10D2197229 CLIA NUMBER - CENTURY OAKS

Laboratory Demographics

  • CLIA Code: 10D2197229
  • Facility Name: CENTURY OAKS
  • Facility Address: 4001 STACK BLVD
    MELBOURNE, FL
    ZIP 32901
  • Facility Phone: 321 722-4440
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: DECOYA L. JACKSON
  • NPI Number: 1699219345
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2197229
LAB Type Assisted Living Facility
Facility Name CENTURY OAKS
Street 4001 STACK BLVD
City MELBOURNE
State FL
ZIP 32901
Phone 321 722-4440
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2024
Certificate Expiration Date 10/21/2026
Facility Type Assisted Living Facility
Lab Director DECOYA L. JACKSON

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