10D2242894 CLIA NUMBER - FILL RX LLC

Laboratory Demographics

  • CLIA Code: 10D2242894
  • Facility Name: FILL RX LLC
  • Facility Address: 776 DELTONA BLVD
    DELTONA, FL
    ZIP 32725
  • Facility Phone: 386 259-4074
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TULSI PATEL
  • NPI Number: 1104270404
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2242894
LAB Type Pharmacy
Facility Name FILL RX LLC
Street 776 DELTONA BLVD
City DELTONA
State FL
ZIP 32725
Phone 386 259-4074
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Pharmacy
Lab Director TULSI PATEL

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