10D2143202 CLIA NUMBER - BROOKSVILLE RX LLC

Laboratory Demographics

  • CLIA Code: 10D2143202
  • Facility Name: BROOKSVILLE RX LLC
  • Facility Address: 80 PONCE DE LEON BLVD
    BROOKSVILLE, FL
    ZIP 34601
  • Facility Phone: 352 796-4975
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LORI A. WEESNER
  • NPI Number: 1366149254
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2143202
LAB Type Pharmacy
Facility Name BROOKSVILLE RX LLC
Street 80 PONCE DE LEON BLVD
City BROOKSVILLE
State FL
ZIP 34601
Phone 352 796-4975
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/13/2025
Certificate Expiration Date 1/12/2027
Facility Type Pharmacy
Lab Director LORI A. WEESNER

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