10D2055358 CLIA NUMBER - CENTRAL FLORIDA KIDNEY SPECIALISTS INC

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Laboratory Demographics

CLIA Number: 10D2055358

Facility Name: CENTRAL FLORIDA KIDNEY SPECIALISTS INC

Facility Address:
3885 OAKWATER CIRCLE SUITE B
ORLANDO, FL
ZIP 32806
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Facility Phone Number: 407 472-5120

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1114064565

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2055358
LAB Type	Ambulatory Surgery Center
Facility Name	CENTRAL FLORIDA KIDNEY SPECIALISTS INC
Street	3885 OAKWATER CIRCLE SUITE B
City	ORLANDO
State	FL
ZIP	32806
Phone	407 472-5120
CertificateType	4
CertificateEffectiveDate	3/11/2023
CertificateExpirationDate	3/10/2025
FacilityType	Waiver

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