10D1027482 CLIA NUMBER - NEMOURS CHILDRENS CLINIC

Laboratory Demographics

CLIA Number: 10D1027482

Facility Name: NEMOURS CHILDRENS CLINIC

Facility Address:
1717 S ORANGE AVE STE 100 ATTN DENNIS DREHNER, MD
ORLANDO, FL
ZIP 32806
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Facility Phone Number: 407 650-7000

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1215505508

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1027482
LAB Type	Physician Office
Facility Name	NEMOURS CHILDRENS CLINIC
Street	1717 S ORANGE AVE STE 100 ATTN DENNIS DREHNER, MD
City	ORLANDO
State	FL
ZIP	32806
Phone	407 650-7000
CertificateType	4
CertificateEffectiveDate	12/2/2023
CertificateExpirationDate	12/1/2025
FacilityType	Waiver

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