10D2136894 CLIA NUMBER - SEABREEZE MEDICAL, PA

Laboratory Demographics

  • CLIA Code: 10D2136894
  • Facility Name: SEABREEZE MEDICAL, PA
  • Facility Address: 320 3RD STREET STE B
    NEPTUNE BEACH, FL
    ZIP 32266
  • Facility Phone: 904 699-2620
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DEBORAH L. GHANDOUR
  • NPI Number: 1487172094
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2136894
LAB Type Physician Office
Facility Name SEABREEZE MEDICAL, PA
Street 320 3RD STREET STE B
City NEPTUNE BEACH
State FL
ZIP 32266
Phone 904 699-2620
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/18/2023
Certificate Expiration Date 9/17/2025
Facility Type Physician Office
Lab Director DEBORAH L. GHANDOUR

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This page was last updated on: 3/20/2025