10D2162509 CLIA NUMBER - BREVARD HEALTH GROUP LLC

Laboratory Demographics

  • CLIA Code: 10D2162509
  • Facility Name: BREVARD HEALTH GROUP LLC
  • Facility Address: 7332 OFFICE PARK PLACE SUITE 103
    MELBOURNE, FL
    ZIP 32940
  • Facility Phone: 248 707-0920
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIJAY KATUKURI
  • NPI Number: 1346723244
  • Taxonomy: 208VP0014X - Pain Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2162509
LAB Type Physician Office
Facility Name BREVARD HEALTH GROUP LLC
Street 7332 OFFICE PARK PLACE SUITE 103
City MELBOURNE
State FL
ZIP 32940
Phone 248 707-0920
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/25/2025
Certificate Expiration Date 2/24/2027
Facility Type Physician Office
Lab Director VIJAY KATUKURI

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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