10D2188027 CLIA NUMBER - MARK MINOR MD PA DBA MINOR ALLERGY IN BREVARD

Laboratory Demographics

  • CLIA Code: 10D2188027
  • Facility Name: MARK MINOR MD PA DBA MINOR ALLERGY IN BREVARD
  • Facility Address: 3021 W EAU GALLIE BLVD SUITE 102
    MELBOURNE, FL
    ZIP 32934
  • Facility Phone: 321 757-5550
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARK MINOR
  • NPI Number: 1982609657
  • Taxonomy: 207KA0200X - Allergy & Immunology

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CLIA Record

Field Name Field Value
CLIA Number 10D2188027
LAB Type Physician Office
Facility Name MARK MINOR MD PA DBA MINOR ALLERGY IN BREVARD
Street 3021 W EAU GALLIE BLVD SUITE 102
City MELBOURNE
State FL
ZIP 32934
Phone 321 757-5550
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/10/2024
Certificate Expiration Date 7/9/2026
Facility Type Physician Office
Lab Director MARK MINOR

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