10D2185641 CLIA NUMBER - GRAND VILLA OF ORMOND BEACH

Laboratory Demographics

  • CLIA Code: 10D2185641
  • Facility Name: GRAND VILLA OF ORMOND BEACH
  • Facility Address: 535 N NOVA RD
    ORMOND BEACH, FL
    ZIP 32174
  • Facility Phone: 386 673-5000
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DANNY WEESE
  • NPI Number: 1326381609
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2185641
LAB Type Assisted Living Facility
Facility Name GRAND VILLA OF ORMOND BEACH
Street 535 N NOVA RD
City ORMOND BEACH
State FL
ZIP 32174
Phone 386 673-5000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2024
Certificate Expiration Date 6/5/2026
Facility Type Assisted Living Facility
Lab Director DANNY WEESE

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This page was last updated on: 6/4/2025