CLIA lab
CLIA 10D0961657: Space Coast Internal Med & Geriatrics
Port Saint John, FL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 10D0961657 belongs to Space Coast Internal Med & Geriatrics in Port Saint John, FL.
Certificate of Waiver, effective February 1, 2026, expires January 31, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- February 1, 2026
- Certificate expiration
- January 31, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 14, 1999
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 10D0961657
- Lab name
- Space Coast Internal Med & Geriatrics
- Address
- 990 Palm St, Port Saint John, FL 32927
- Phone
- (321) 639-4243
- Fax
- (321) 639-4266
Annual test volume the lab reported
- Waived tests
- 3,560
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Port Saint John, FL
- Branko D Pejic MD Family PracticeCertificate of Waiver, Physician office10D0993387
- Medfast Urgent Care Centers LLCCertificate of Waiver, Other10D2006323
- North Brevard Medical SupportCertificate of Waiver, Physician office10D2133645
- Parrish Healthcare at Port ST JohnCertificate of Waiver, Ancillary test site10D1019927
- Space Coast Cardiology ConsultantsCertificate of Waiver, Physician office10D0993769
Related
Questions
What is the CLIA number for Space Coast Internal Med & Geriatrics in Port Saint John?
10D0961657, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Space Coast Internal Med & Geriatrics hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 10D0961657 expire?
The CMS file lists January 31, 2028 as the certificate expiration date; the certificate took effect February 1, 2026.