10D2035543 CLIA NUMBER - COMMUNITY MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 10D2035543
  • Facility Name: COMMUNITY MEDICAL CENTER
  • Facility Address: 126 S COUNTY RD STE 315
    INTERLACHEN, FL
    ZIP 32148
  • Facility Phone: 386 684-4685
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOUSTAFA ELDICK
  • NPI Number: 1639437569
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2035543
LAB Type Physician Office
Facility Name COMMUNITY MEDICAL CENTER
Street 126 S COUNTY RD STE 315
City INTERLACHEN
State FL
ZIP 32148
Phone 386 684-4685
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type Physician Office
Lab Director MOUSTAFA ELDICK

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