10D0892896 CLIA NUMBER - KISSIMMEE FIRE DEPARTMENT

Laboratory Demographics

CLIA Number: 10D0892896

Facility Name: KISSIMMEE FIRE DEPARTMENT

Facility Address:
343 N CLYDE AVE
KISSIMMEE, FL
ZIP 34741
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Facility Phone Number: 407 518-2222

Facility Type: Mobile Laboratory

Certificate Type: Waiver

NPI Number: 1053863373

Taxonomy: 2085R0202X - Radiology
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

CLIA Record

Field Name	Field Value
CLIA Number	10D0892896
LAB Type	Mobile Laboratory
Facility Name	KISSIMMEE FIRE DEPARTMENT
Street	343 N CLYDE AVE
City	KISSIMMEE
State	FL
ZIP	34741
Phone	407 518-2222
CertificateType	4
CertificateEffectiveDate	10/11/2022
CertificateExpirationDate	10/10/2024
FacilityType	Waiver

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