10D1070456 CLIA NUMBER - EVANS FAMILY CARE PA

Laboratory Demographics

CLIA Number: 10D1070456

Facility Name: EVANS FAMILY CARE PA

Facility Address:
1317 N PINE HILLS RD
ORLANDO, FL
ZIP 32802
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Facility Phone Number: 407 532-4615

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1548452600

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D1070456
LAB Type	Physician Office
Facility Name	EVANS FAMILY CARE PA
Street	1317 N PINE HILLS RD
City	ORLANDO
State	FL
ZIP	32802
Phone	407 532-4615
CertificateType	4
CertificateEffectiveDate	6/28/2023
CertificateExpirationDate	6/27/2025
FacilityType	Waiver

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