10D1100239 CLIA NUMBER - FLORIDA SPINE CARE CENTER

Laboratory Demographics

CLIA Number: 10D1100239

Facility Name: FLORIDA SPINE CARE CENTER

Facility Address:
1405 SOUTH ORANGE AVE SUITE 200
ORLANDO, FL
ZIP 32806
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Facility Phone Number: 407 481-2244

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1881874154

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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
CertificateType	4
CertificateEffectiveDate	6/2/2023
CertificateExpirationDate	6/1/2025
FacilityType	Waiver

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