10D2017595 CLIA NUMBER - ORLANDO HEALTH CLINIC LLC

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Laboratory Demographics

CLIA Number: 10D2017595

Facility Name: ORLANDO HEALTH CLINIC LLC

Facility Address:
823 N MILLS AVE
ORLANDO, FL
ZIP 32803
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Facility Phone Number: 407 895-5402

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1437486339

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D2017595
LAB Type	Physician Office
Facility Name	ORLANDO HEALTH CLINIC LLC
Street	823 N MILLS AVE
City	ORLANDO
State	FL
ZIP	32803
Phone	407 895-5402
CertificateType	4
CertificateEffectiveDate	12/14/2022
CertificateExpirationDate	12/13/2024
FacilityType	Waiver

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