10D2307452 CLIA NUMBER - NP BY THE SEA LLC DBA THE SALT CLINIC

Laboratory Demographics

  • CLIA Code: 10D2307452
  • Facility Name: NP BY THE SEA LLC DBA THE SALT CLINIC
  • Facility Address: 725 W GRANADA BLVD STE 30
    ORMOND BEACH, FL
    ZIP 32174
  • Facility Phone: 386 238-9095
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JORDAN R. ROBERSON
  • NPI Number: 1245983360
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2307452
LAB Type Practitioner Other
Facility Name NP BY THE SEA LLC DBA THE SALT CLINIC
Street 725 W GRANADA BLVD STE 30
City ORMOND BEACH
State FL
ZIP 32174
Phone 386 238-9095
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2024
Certificate Expiration Date 7/8/2026
Facility Type Practitioner Other
Lab Director JORDAN R. ROBERSON

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