10D1074203 CLIA NUMBER - ENRIQUE G GUTIERREZ MD PA

Laboratory Demographics

  • CLIA Code: 10D1074203
  • Facility Name: ENRIQUE G GUTIERREZ MD PA
  • Facility Address: 907 NORTH CENTRAL AVE STE A
    KISSIMMEE, FL
    ZIP 34741
  • Facility Phone: 407 846-2050
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ENRIQUE G. GUTIERREZ MD
  • NPI Number: 1407951304
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1074203
LAB Type Physician Office
Facility Name ENRIQUE G GUTIERREZ MD PA
Street 907 NORTH CENTRAL AVE STE A
City KISSIMMEE
State FL
ZIP 34741
Phone 407 846-2050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/25/2025
Certificate Expiration Date 9/24/2027
Facility Type Physician Office
Lab Director ENRIQUE G. GUTIERREZ MD

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