10D2165499 CLIA NUMBER - EDGEWATER CHIROPRACTIC CLINIC PA

Laboratory Demographics

  • CLIA Code: 10D2165499
  • Facility Name: EDGEWATER CHIROPRACTIC CLINIC PA
  • Facility Address: 201 S RIDGEWOOD AVE STE #11
    EDGEWATER, FL
    ZIP 32132
  • Facility Phone: 386 423-7575
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CARLY D. MECKLE
  • NPI Number: 1821421363
  • Taxonomy: 111N00000X - Chiropractor

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CLIA Record

Field Name Field Value
CLIA Number 10D2165499
LAB Type Physician Office
Facility Name EDGEWATER CHIROPRACTIC CLINIC PA
Street 201 S RIDGEWOOD AVE STE #11
City EDGEWATER
State FL
ZIP 32132
Phone 386 423-7575
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2025
Certificate Expiration Date 4/29/2027
Facility Type Physician Office
Lab Director CARLY D. MECKLE

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