10D2014981 CLIA NUMBER - LAKE WASHINGTON FOOT & ANKLE

Laboratory Demographics

  • CLIA Code: 10D2014981
  • Facility Name: LAKE WASHINGTON FOOT & ANKLE
  • Facility Address: 2717 N WICKHAM ROAD SUITE 4
    MELBOURNE, FL
    ZIP 32935
  • Facility Phone: 321 253-6191
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ROBERT P. DUNNE
  • NPI Number: 1639328396
  • Taxonomy: 213ES0103X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 10D2014981
LAB Type Physician Office
Facility Name LAKE WASHINGTON FOOT & ANKLE
Street 2717 N WICKHAM ROAD SUITE 4
City MELBOURNE
State FL
ZIP 32935
Phone 321 253-6191
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/11/2025
Certificate Expiration Date 3/10/2027
Facility Type Physician Office
Lab Director ROBERT P. DUNNE

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This page was last updated on: 9/29/2025