10D0669044 CLIA NUMBER - SURGICAL GROUP OF ORLANDO,THE

Laboratory Demographics

CLIA Number: 10D0669044

Facility Name: SURGICAL GROUP OF ORLANDO,THE

Facility Address:
1814 LUCERNE TERRACE
ORLANDO, FL
ZIP 32806
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Facility Phone Number: 407 730-3627

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1417041468

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0669044
LAB Type	Physician Office
Facility Name	SURGICAL GROUP OF ORLANDO,THE
Street	1814 LUCERNE TERRACE
City	ORLANDO
State	FL
ZIP	32806
Phone	407 730-3627
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024