10D2060012 CLIA NUMBER - SOUTHERN RESPIRATORY

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CLIA Record

Field Name Field Value
CLIA Number 10D2060012
LAB Type Other - RESPIRATORY SERVICES
Facility Name SOUTHERN RESPIRATORY
Street 724 S ROSSITER ST
City MOUNT DORA
State FL
ZIP 32757
Phone 352 385-9116
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2025
Certificate Expiration Date 6/4/2027
Facility Type Other - RESPIRATORY SERVICES
Lab Director MARK L. HICKS

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