10D2054178 CLIA NUMBER - SACOWI MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 10D2054178
  • Facility Name: SACOWI MEDICAL CLINIC
  • Facility Address: 931 WEKIVA SPRINGS RD
    LONGWOOD, FL
    ZIP 32779
  • Facility Phone: 407 960-6075
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAMUEL JEAN
  • NPI Number: 1952648974
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2054178
LAB Type Physician Office
Facility Name SACOWI MEDICAL CLINIC
Street 931 WEKIVA SPRINGS RD
City LONGWOOD
State FL
ZIP 32779
Phone 407 960-6075
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2025
Certificate Expiration Date 2/14/2027
Facility Type Physician Office
Lab Director SAMUEL JEAN

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This page was last updated on: 6/4/2025