10D2233661 CLIA NUMBER - MANGALMURTI LLC DBA MOUNT DORA PHARMACY

Laboratory Demographics

  • CLIA Code: 10D2233661
  • Facility Name: MANGALMURTI LLC DBA MOUNT DORA PHARMACY
  • Facility Address: 17435 US HIGHWAY 441 SUITE 102
    EUSTIS, FL
    ZIP 32726
  • Facility Phone: 352 357-1406
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JIMIN K. PATEL
  • NPI Number: 1063773679
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2233661
LAB Type Pharmacy
Facility Name MANGALMURTI LLC DBA MOUNT DORA PHARMACY
Street 17435 US HIGHWAY 441 SUITE 102
City EUSTIS
State FL
ZIP 32726
Phone 352 357-1406
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2025
Certificate Expiration Date 8/24/2027
Facility Type Pharmacy
Lab Director JIMIN K. PATEL

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