10D1100239 CLIA NUMBER - FLORIDA SPINE CARE CENTER

Laboratory Demographics

  • CLIA Code: 10D1100239
  • Facility Name: FLORIDA SPINE CARE CENTER
  • Facility Address: 1405 SOUTH ORANGE AVE SUITE 200
    ORLANDO, FL
    ZIP 32806
  • Facility Phone: 407 481-2244
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL J. BROOM
  • NPI Number: 1881874154
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 10D1100239
LAB Type Physician Office
Facility Name FLORIDA SPINE CARE CENTER
Street 1405 SOUTH ORANGE AVE SUITE 200
City ORLANDO
State FL
ZIP 32806
Phone 407 481-2244
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/2/2025
Certificate Expiration Date 6/1/2027
Facility Type Physician Office
Lab Director MICHAEL J. BROOM

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