10D2123292 CLIA NUMBER - NORTH BREVARD DIALYSIS

Laboratory Demographics

  • CLIA Code: 10D2123292
  • Facility Name: NORTH BREVARD DIALYSIS
  • Facility Address: 250 HARRISON STREET STE 110
    TITUSVILLE, FL
    ZIP 32780
  • Facility Phone: 321 383-1345
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: IMRAN RASHID
  • NPI Number: 1962851006
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2123292
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name NORTH BREVARD DIALYSIS
Street 250 HARRISON STREET STE 110
City TITUSVILLE
State FL
ZIP 32780
Phone 321 383-1345
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2024
Certificate Expiration Date 12/15/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director IMRAN RASHID

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