10D2238378 CLIA NUMBER - KANOKRAT CLINIC LLC

Laboratory Demographics

  • CLIA Code: 10D2238378
  • Facility Name: KANOKRAT CLINIC LLC
  • Facility Address: 1415 NORTH ATLANTIC AVE
    COCOA BEACH, FL
    ZIP 32931
  • Facility Phone: 321 417-1557
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: TEE WELLS
  • NPI Number: 1972271245
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2238378
LAB Type Community Clinic
Facility Name KANOKRAT CLINIC LLC
Street 1415 NORTH ATLANTIC AVE
City COCOA BEACH
State FL
ZIP 32931
Phone 321 417-1557
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2023
Certificate Expiration Date 10/3/2025
Facility Type Community Clinic
Lab Director TEE WELLS

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