10D2249459 CLIA NUMBER - BREVARD PHARMACY LLC

Laboratory Demographics

  • CLIA Code: 10D2249459
  • Facility Name: BREVARD PHARMACY LLC
  • Facility Address: 401 BARTON BLVD
    ROCKLEDGE, FL
    ZIP 32955
  • Facility Phone: 321 305-6975
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAJESH A. PATEL
  • NPI Number: 1174168322
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2249459
LAB Type Pharmacy
Facility Name BREVARD PHARMACY LLC
Street 401 BARTON BLVD
City ROCKLEDGE
State FL
ZIP 32955
Phone 321 305-6975
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/20/2024
Certificate Expiration Date 1/19/2026
Facility Type Pharmacy
Lab Director RAJESH A. PATEL

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