10D2171496 CLIA NUMBER - ERICA L O'DONNELL DO PA

Laboratory Demographics

  • CLIA Code: 10D2171496
  • Facility Name: ERICA L O'DONNELL DO PA
  • Facility Address: 1400 HAND AVE STE K
    ORMOND BEACH, FL
    ZIP 32174
  • Facility Phone: 386 671-2771
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERICA L. ODONNELL
  • NPI Number: 1407887029
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2171496
LAB Type Physician Office
Facility Name ERICA L O'DONNELL DO PA
Street 1400 HAND AVE STE K
City ORMOND BEACH
State FL
ZIP 32174
Phone 386 671-2771
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/3/2025
Certificate Expiration Date 9/2/2027
Facility Type Physician Office
Lab Director ERICA L. ODONNELL

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