10D2263914 CLIA NUMBER - MEDFAST URGENT CARE CENTERS, LLC

Laboratory Demographics

CLIA Number: 10D2263914

Facility Name: MEDFAST URGENT CARE CENTERS, LLC

Facility Address:
2525 GARDEN ST
TITUSVILLE, FL
ZIP 32796
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Facility Phone Number: 321 633-3278

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1174262232

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2263914
LAB Type	Other - URGENT CARE
Facility Name	MEDFAST URGENT CARE CENTERS, LLC
Street	2525 GARDEN ST
City	TITUSVILLE
State	FL
ZIP	32796
Phone	321 633-3278
CertificateType	4
CertificateEffectiveDate	7/7/2022
CertificateExpirationDate	7/6/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024