10D2030149 CLIA NUMBER - ADVENTHEALTH CORPORATE CARE DAVENPORT

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Laboratory Demographics

CLIA Number: 10D2030149

Facility Name: ADVENTHEALTH CORPORATE CARE DAVENPORT

Facility Address:
40124 US HWY 27 - SUITE 205
DAVENPORT, FL
ZIP 33837
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Facility Phone Number: 407 200-2782

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1689221269

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2030149
LAB Type	Other - URGENT CARE
Facility Name	ADVENTHEALTH CORPORATE CARE DAVENPORT
Street	40124 US HWY 27 - SUITE 205
City	DAVENPORT
State	FL
ZIP	33837
Phone	407 200-2782
CertificateType	4
CertificateEffectiveDate	9/22/2023
CertificateExpirationDate	9/21/2025
FacilityType	Waiver

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