10D0921154 CLIA NUMBER - ORLANDO NORTH DIALYSIS

Laboratory Demographics

CLIA Number: 10D0921154

Facility Name: ORLANDO NORTH DIALYSIS

Facility Address:
5135 ADANSON ST STE 700
ORLANDO, FL
ZIP 32804
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Facility Phone Number: 407 539-3998

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1770551012

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0921154
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	ORLANDO NORTH DIALYSIS
Street	5135 ADANSON ST STE 700
City	ORLANDO
State	FL
ZIP	32804
Phone	407 539-3998
CertificateType	4
CertificateEffectiveDate	10/21/2022
CertificateExpirationDate	10/20/2024
FacilityType	Waiver

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