10D0867377 CLIA NUMBER - JACK T WEAVER DPM DO MD PA

Laboratory Demographics

  • CLIA Code: 10D0867377
  • Facility Name: JACK T WEAVER DPM DO MD PA
  • Facility Address: 3120 CORRINE DR
    ORLANDO, FL
    ZIP 32803
  • Facility Phone: 407 257-6100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HOWARD WEAVER
  • NPI Number: 1063583904
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0867377
LAB Type Physician Office
Facility Name JACK T WEAVER DPM DO MD PA
Street 3120 CORRINE DR
City ORLANDO
State FL
ZIP 32803
Phone 407 257-6100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/25/2025
Certificate Expiration Date 2/24/2027
Facility Type Physician Office
Lab Director HOWARD WEAVER

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