10D2280177 CLIA NUMBER - SPACE COAST VASCULAR INTERVENTIONAL RADIOLOGY

Laboratory Demographics

  • CLIA Code: 10D2280177
  • Facility Name: SPACE COAST VASCULAR INTERVENTIONAL RADIOLOGY
  • Facility Address: 336 N BABCOCK ST, SUITE #101
    MELBOURNE, FL
    ZIP 32935
  • Facility Phone: 321 364-1001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AKASH PATEL
  • NPI Number: 1922404441
  • Taxonomy: 363AS0400X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 10D2280177
LAB Type Physician Office
Facility Name SPACE COAST VASCULAR INTERVENTIONAL RADIOLOGY
Street 336 N BABCOCK ST, SUITE #101
City MELBOURNE
State FL
ZIP 32935
Phone 321 364-1001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Physician Office
Lab Director AKASH PATEL

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