10D2086122 CLIA NUMBER - JOHNNY GURGEN DO PA

Laboratory Demographics

  • CLIA Code: 10D2086122
  • Facility Name: JOHNNY GURGEN DO PA
  • Facility Address: 920 ROLLING ACRES RD SUITE 204
    LADY LAKE, FL
    ZIP 32159
  • Facility Phone: 352 435-7695
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: JOHNNY GURGEN
  • NPI Number: 1962666966
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 10D2086122
LAB Type Physician Office
Facility Name JOHNNY GURGEN DO PA
Street 920 ROLLING ACRES RD SUITE 204
City LADY LAKE
State FL
ZIP 32159
Phone 352 435-7695
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 1/29/2025
Certificate Expiration Date 1/28/2027
Facility Type Physician Office
Lab Director JOHNNY GURGEN

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