10D1024528 CLIA NUMBER - POTHEN KORUTH MD LLC

Laboratory Demographics

  • CLIA Code: 10D1024528
  • Facility Name: POTHEN KORUTH MD LLC
  • Facility Address: 758 N SUN DR STE 104
    LAKE MARY, FL
    ZIP 32746
  • Facility Phone: 407 333-3303
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: POTHEN C. KORUTH MD
  • NPI Number: 1093768400
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D1024528
LAB Type Physician Office
Facility Name POTHEN KORUTH MD LLC
Street 758 N SUN DR STE 104
City LAKE MARY
State FL
ZIP 32746
Phone 407 333-3303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2024
Certificate Expiration Date 4/13/2026
Facility Type Physician Office
Lab Director POTHEN C. KORUTH MD

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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