10D2058545 CLIA NUMBER - MID FLORIDA EYE

Laboratory Demographics

  • CLIA Code: 10D2058545
  • Facility Name: MID FLORIDA EYE
  • Facility Address: 17556 SE 109TH TERR RD
    SUMMERFIELD, FL
    ZIP 34491
  • Facility Phone: 352 735-2020
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. KEITH CHARLES
  • NPI Number: 1558440354
  • Taxonomy: 207W00000X - Ophthalmology

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CLIA Record

Field Name Field Value
CLIA Number 10D2058545
LAB Type Physician Office
Facility Name MID FLORIDA EYE
Street 17556 SE 109TH TERR RD
City SUMMERFIELD
State FL
ZIP 34491
Phone 352 735-2020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2025
Certificate Expiration Date 5/8/2027
Facility Type Physician Office
Lab Director DR. KEITH CHARLES

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This page was last updated on: 9/29/2025