10D2148531 CLIA NUMBER - PALM BAY RX PHARMACY LLC

Laboratory Demographics

  • CLIA Code: 10D2148531
  • Facility Name: PALM BAY RX PHARMACY LLC
  • Facility Address: 1270 MALABAR RD SE SUITE #2
    PALM BAY, FL
    ZIP 32907
  • Facility Phone: 321 952-0656
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EDY PAYOUTE
  • NPI Number: 1790747483
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2148531
LAB Type Pharmacy
Facility Name PALM BAY RX PHARMACY LLC
Street 1270 MALABAR RD SE SUITE #2
City PALM BAY
State FL
ZIP 32907
Phone 321 952-0656
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2024
Certificate Expiration Date 5/13/2026
Facility Type Pharmacy
Lab Director EDY PAYOUTE

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