10D1102318 CLIA NUMBER - CONCENTRA - ORLANDO NORTH

Laboratory Demographics

CLIA Number: 10D1102318

Facility Name: CONCENTRA - ORLANDO NORTH

Facility Address:
4780 N ORANGE BLOSSOM TRL
ORLANDO, FL
ZIP 32837
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Facility Phone Number: 407 206-3326

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124505128

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1102318
LAB Type	Physician Office
Facility Name	CONCENTRA - ORLANDO NORTH
Street	4780 N ORANGE BLOSSOM TRL
City	ORLANDO
State	FL
ZIP	32837
Phone	407 206-3326
CertificateType	4
CertificateEffectiveDate	7/16/2023
CertificateExpirationDate	7/15/2025
FacilityType	Waiver

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