10D2125905 CLIA NUMBER - PHPTS OF ORMOND BEACH LLC

Laboratory Demographics

  • CLIA Code: 10D2125905
  • Facility Name: PHPTS OF ORMOND BEACH LLC
  • Facility Address: 515 TOMOKA AVE
    ORMOND BEACH, FL
    ZIP 32174
  • Facility Phone: 615 567-7266
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAVID A. HEISE
  • NPI Number: 1457898744
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2125905
LAB Type Physician Office
Facility Name PHPTS OF ORMOND BEACH LLC
Street 515 TOMOKA AVE
City ORMOND BEACH
State FL
ZIP 32174
Phone 615 567-7266
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2025
Certificate Expiration Date 2/14/2027
Facility Type Physician Office
Lab Director DAVID A. HEISE

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