10D2016558 CLIA NUMBER - EAST COLONIAL FAMILY MEDICAL CENTER

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Laboratory Demographics

CLIA Number: 10D2016558

Facility Name: EAST COLONIAL FAMILY MEDICAL CENTER

Facility Address:
9464 E COLONIAL DR
ORLANDO, FL
ZIP 32817
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Facility Phone Number: 407 482-9788

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1144523531

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2016558
LAB Type	Physician Office
Facility Name	EAST COLONIAL FAMILY MEDICAL CENTER
Street	9464 E COLONIAL DR
City	ORLANDO
State	FL
ZIP	32817
Phone	407 482-9788
CertificateType	4
CertificateEffectiveDate	11/19/2022
CertificateExpirationDate	11/18/2024
FacilityType	Waiver

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