10D1064686 CLIA NUMBER - ORLANDO PHYSICIAN NETWORK

Laboratory Demographics

  • CLIA Code: 10D1064686
  • Facility Name: ORLANDO PHYSICIAN NETWORK
  • Facility Address: 1134 KELTON AVE SUITE A
    OCOEE, FL
    ZIP 34761
  • Facility Phone: 407 306-6306
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAVINDRA S. TAK
  • NPI Number: 1639842081
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1064686
LAB Type Physician Office
Facility Name ORLANDO PHYSICIAN NETWORK
Street 1134 KELTON AVE SUITE A
City OCOEE
State FL
ZIP 34761
Phone 407 306-6306
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Physician Office
Lab Director RAVINDRA S. TAK

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This page was last updated on: 6/4/2025