10D2033728 CLIA NUMBER - ORANGE DOC FAMILY MEDICINE PLLC

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Laboratory Demographics

CLIA Number: 10D2033728

Facility Name: ORANGE DOC FAMILY MEDICINE PLLC

Facility Address:
835 7TH ST STE 5
CLERMONT, FL
ZIP 34711
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Facility Phone Number: 352 404-8961

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1316226657

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2033728
LAB Type	Physician Office
Facility Name	ORANGE DOC FAMILY MEDICINE PLLC
Street	835 7TH ST STE 5
City	CLERMONT
State	FL
ZIP	34711
Phone	352 404-8961
CertificateType	4
CertificateEffectiveDate	12/8/2023
CertificateExpirationDate	12/7/2025
FacilityType	Waiver

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