10D1106775 CLIA NUMBER - WELLMED MEDICAL MANAGEMENT OF FLORIDA INC DBA WELLMED AT ST CLOUD

Laboratory Demographics

  • CLIA Code: 10D1106775
  • Facility Name: WELLMED MEDICAL MANAGEMENT OF FLORIDA INC DBA WELLMED AT ST CLOUD
  • Facility Address: 4513 OLD CANOE CREEK RD
    SAINT CLOUD, FL
    ZIP 34769
  • Facility Phone: 407 498-0461
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELBA E. MASID
  • NPI Number: 1811918709
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1106775
LAB Type Physician Office
Facility Name WELLMED MEDICAL MANAGEMENT OF FLORIDA INC DBA WELLMED AT ST CLOUD
Street 4513 OLD CANOE CREEK RD
City SAINT CLOUD
State FL
ZIP 34769
Phone 407 498-0461
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/22/2023
Certificate Expiration Date 10/21/2025
Facility Type Physician Office
Lab Director ELBA E. MASID

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