10D1053786 CLIA NUMBER - ORLANDO PHYSICIAN NETWORK

Laboratory Demographics

  • CLIA Code: 10D1053786
  • Facility Name: ORLANDO PHYSICIAN NETWORK
  • Facility Address: 9679 LAKE NONA VILLAGE PLACE STE 102,103,104
    ORLANDO, FL
    ZIP 32827
  • Facility Phone: 407 649-7413
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL GODDARD
  • NPI Number: 1306510615
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D1053786
LAB Type Physician Office
Facility Name ORLANDO PHYSICIAN NETWORK
Street 9679 LAKE NONA VILLAGE PLACE STE 102,103,104
City ORLANDO
State FL
ZIP 32827
Phone 407 649-7413
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2024
Certificate Expiration Date 9/15/2026
Facility Type Physician Office
Lab Director DANIEL GODDARD

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