10D2059089 CLIA NUMBER - COASTAL NEUROLOGY INC

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Laboratory Demographics

CLIA Number: 10D2059089

Facility Name: COASTAL NEUROLOGY INC

Facility Address:
725 W GRANADA BLVD STE 22
ORMOND BEACH, FL
ZIP 32174
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Facility Phone Number: 386 788-2300

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1457358434

Taxonomy: 2084N0400X - Psychiatry & Neurology
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

CLIA Record

Field Name	Field Value
CLIA Number	10D2059089
LAB Type	Physician Office
Facility Name	COASTAL NEUROLOGY INC
Street	725 W GRANADA BLVD STE 22
City	ORMOND BEACH
State	FL
ZIP	32174
Phone	386 788-2300
CertificateType	1
CertificateEffectiveDate	8/14/2023
CertificateExpirationDate	8/13/2025
FacilityType	Accreditation

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This page was last updated on: 4/23/2024