10D2279106 CLIA NUMBER - BAYSIDE LAKES FAMILY CARE

Laboratory Demographics

  • CLIA Code: 10D2279106
  • Facility Name: BAYSIDE LAKES FAMILY CARE
  • Facility Address: 336 COGAN DRIVE SE
    PALM BAY, FL
    ZIP 32909
  • Facility Phone: 321 462-4001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIKASH ROUADARSJO
  • NPI Number: 1932686615
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D2279106
LAB Type Physician Office
Facility Name BAYSIDE LAKES FAMILY CARE
Street 336 COGAN DRIVE SE
City PALM BAY
State FL
ZIP 32909
Phone 321 462-4001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Physician Office
Lab Director VIKASH ROUADARSJO

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