10D2042336 CLIA NUMBER - LAKE CONWAY URGENT CARE LLC

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Laboratory Demographics

CLIA Number: 10D2042336

Facility Name: LAKE CONWAY URGENT CARE LLC

Facility Address:
5050 S CONWAY RD SUITE 2
ORLANDO, FL
ZIP 32812
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Facility Phone Number: 407 851-2790

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1215218532

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2042336
LAB Type	Physician Office
Facility Name	LAKE CONWAY URGENT CARE LLC
Street	5050 S CONWAY RD SUITE 2
City	ORLANDO
State	FL
ZIP	32812
Phone	407 851-2790
CertificateType	4
CertificateEffectiveDate	6/8/2022
CertificateExpirationDate	6/7/2024
FacilityType	Waiver

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