10D2008132 CLIA NUMBER - FLORIDA DIALYSIS CENTER OF ORLANDO LLC

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Laboratory Demographics

CLIA Number: 10D2008132

Facility Name: FLORIDA DIALYSIS CENTER OF ORLANDO LLC

Facility Address:
1711 35TH ST STE 109/110
ORLANDO, FL
ZIP 32839
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Facility Phone Number: 407 648-9722

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1538482740

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2008132
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	FLORIDA DIALYSIS CENTER OF ORLANDO LLC
Street	1711 35TH ST STE 109/110
City	ORLANDO
State	FL
ZIP	32839
Phone	407 648-9722
CertificateType	4
CertificateEffectiveDate	6/4/2022
CertificateExpirationDate	6/3/2024
FacilityType	Waiver

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