10D2155879 CLIA NUMBER - BENEZRA GYNECOLOGY LLC

Laboratory Demographics

  • CLIA Code: 10D2155879
  • Facility Name: BENEZRA GYNECOLOGY LLC
  • Facility Address: 129 W HIBISCUS BLVD STE A
    MELBOURNE, FL
    ZIP 32901
  • Facility Phone: 321 405-3000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VICTOR BENEZRA
  • NPI Number: 1225537731
  • Taxonomy: 207VG0400X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 10D2155879
LAB Type Physician Office
Facility Name BENEZRA GYNECOLOGY LLC
Street 129 W HIBISCUS BLVD STE A
City MELBOURNE
State FL
ZIP 32901
Phone 321 405-3000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/8/2024
Certificate Expiration Date 10/7/2026
Facility Type Physician Office
Lab Director VICTOR BENEZRA

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