10D1074191 CLIA NUMBER - ADVENTHEALTH CENTRA CARE SOUTH ORANGE

Laboratory Demographics

CLIA Number: 10D1074191

Facility Name: ADVENTHEALTH CENTRA CARE SOUTH ORANGE

Facility Address:
2609 S ORANGE AVE
ORLANDO, FL
ZIP 32806
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Facility Phone Number: 407 916-4540

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1538579685

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1074191
LAB Type	Other
Facility Name	ADVENTHEALTH CENTRA CARE SOUTH ORANGE
Street	2609 S ORANGE AVE
City	ORLANDO
State	FL
ZIP	32806
Phone	407 916-4540
CertificateType	4
CertificateEffectiveDate	9/25/2023
CertificateExpirationDate	9/24/2025
FacilityType	Waiver

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