10D2323979 CLIA NUMBER - SPACE COAST IV THERAPY & WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 10D2323979
  • Facility Name: SPACE COAST IV THERAPY & WELLNESS CENTER
  • Facility Address: 2404 N COURTENAY PKWY ST D
    MERRITT ISLAND, FL
    ZIP 32953
  • Facility Phone: 321 275-6750
  • Facility Type: Other - WELLNESS CLINIC
  • Facility Type: Waiver
  • Lab Director: TRISHA BEYLIN
  • NPI Number: 1942441753
  • Taxonomy: 207L00000X - Anesthesiology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2323979
LAB Type Other - WELLNESS CLINIC
Facility Name SPACE COAST IV THERAPY & WELLNESS CENTER
Street 2404 N COURTENAY PKWY ST D
City MERRITT ISLAND
State FL
ZIP 32953
Phone 321 275-6750
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/16/2025
Certificate Expiration Date 5/15/2027
Facility Type Other - WELLNESS CLINIC
Lab Director TRISHA BEYLIN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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