10D2130000 CLIA NUMBER - SPACE COAST OPHTHALMOLOGY

Laboratory Demographics

  • CLIA Code: 10D2130000
  • Facility Name: SPACE COAST OPHTHALMOLOGY
  • Facility Address: 1832 GARDEN STREET
    TITUSVILLE, FL
    ZIP 32796
  • Facility Phone: 321 267-0008
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NICHOLAS A. PEFKAROS
  • NPI Number: 1962954107
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 10D2130000
LAB Type Physician Office
Facility Name SPACE COAST OPHTHALMOLOGY
Street 1832 GARDEN STREET
City TITUSVILLE
State FL
ZIP 32796
Phone 321 267-0008
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2025
Certificate Expiration Date 4/30/2027
Facility Type Physician Office
Lab Director NICHOLAS A. PEFKAROS

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