10D0275079 CLIA NUMBER - DOVER SHORES FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 10D0275079
  • Facility Name: DOVER SHORES FAMILY PRACTICE LLC
  • Facility Address: 4711 CURRY FORD RD SUITE B
    ORLANDO, FL
    ZIP 32812
  • Facility Phone: 407 275-9014
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GERALD J. KIVETT MD
  • NPI Number: 1114010824
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0275079
LAB Type Physician Office
Facility Name DOVER SHORES FAMILY PRACTICE LLC
Street 4711 CURRY FORD RD SUITE B
City ORLANDO
State FL
ZIP 32812
Phone 407 275-9014
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Physician Office
Lab Director GERALD J. KIVETT MD

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