10D1102089 CLIA NUMBER - MAGIC CITY OBGYN LLC

Laboratory Demographics

  • CLIA Code: 10D1102089
  • Facility Name: MAGIC CITY OBGYN LLC
  • Facility Address: 3200 HILLSDALE LN
    KISSIMMEE, FL
    ZIP 34741
  • Facility Phone: 407 703-2800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ARNALDO LOPEZ ROMAN
  • NPI Number: 1215164363
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 10D1102089
LAB Type Physician Office
Facility Name MAGIC CITY OBGYN LLC
Street 3200 HILLSDALE LN
City KISSIMMEE
State FL
ZIP 34741
Phone 407 703-2800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2023
Certificate Expiration Date 7/9/2025
Facility Type Physician Office
Lab Director ARNALDO LOPEZ ROMAN

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This page was last updated on: 6/4/2025