10D2185810 CLIA NUMBER - PALM BAY COMMUNITY OUTPATIENT CLINIC

Laboratory Demographics

  • CLIA Code: 10D2185810
  • Facility Name: PALM BAY COMMUNITY OUTPATIENT CLINIC
  • Facility Address: 5200 BABCOCK STREET NE
    PALM BAY, FL
    ZIP 32905
  • Facility Phone: 407 631-0113
  • Facility Type: Community Clinic
  • Facility Type: Accreditation
  • Lab Director: FADY BADDOURA
  • NPI Number: 1598398331
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2185810
LAB Type Community Clinic
Facility Name PALM BAY COMMUNITY OUTPATIENT CLINIC
Street 5200 BABCOCK STREET NE
City PALM BAY
State FL
ZIP 32905
Phone 407 631-0113
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 6/10/2020
Certificate Expiration Date 5/22/2026
Facility Type Community Clinic
Lab Director FADY BADDOURA

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