10D2252281 CLIA NUMBER - RX HEALTHCARE SYSTEM LLC

Laboratory Demographics

  • CLIA Code: 10D2252281
  • Facility Name: RX HEALTHCARE SYSTEM LLC
  • Facility Address: 3755 S NOVA RD UNIT A
    PORT ORANGE, FL
    ZIP 32129
  • Facility Phone: 386 256-3177
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TEJAS MEHTA
  • NPI Number: 1093230831
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2252281
LAB Type Pharmacy
Facility Name RX HEALTHCARE SYSTEM LLC
Street 3755 S NOVA RD UNIT A
City PORT ORANGE
State FL
ZIP 32129
Phone 386 256-3177
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2024
Certificate Expiration Date 2/9/2026
Facility Type Pharmacy
Lab Director TEJAS MEHTA

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