10D0998921 CLIA NUMBER - MEDICAL HOME ALLIANCE

Laboratory Demographics

  • CLIA Code: 10D0998921
  • Facility Name: MEDICAL HOME ALLIANCE
  • Facility Address: 111 WEBB DRIVE
    DAVENPORT, FL
    ZIP 33837
  • Facility Phone: 407 845-0330
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JUAN C. ESCANDON
  • NPI Number: 1356321665
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0998921
LAB Type Physician Office
Facility Name MEDICAL HOME ALLIANCE
Street 111 WEBB DRIVE
City DAVENPORT
State FL
ZIP 33837
Phone 407 845-0330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2024
Certificate Expiration Date 4/28/2026
Facility Type Physician Office
Lab Director JUAN C. ESCANDON

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