10D2092885 CLIA NUMBER - ADVENTHEALTH MEDICAL GROUP FAMILY MEDICINE AT LAKE NONA

Laboratory Demographics

  • CLIA Code: 10D2092885
  • Facility Name: ADVENTHEALTH MEDICAL GROUP FAMILY MEDICINE AT LAKE NONA
  • Facility Address: 9975 TAVISTOCK LAKES BLVD STE 220
    ORLANDO, FL
    ZIP 32827
  • Facility Phone: 407 930-7801
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMIT DESAI
  • NPI Number: 1942873476
  • Taxonomy: 261QP2000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2092885
LAB Type Physician Office
Facility Name ADVENTHEALTH MEDICAL GROUP FAMILY MEDICINE AT LAKE NONA
Street 9975 TAVISTOCK LAKES BLVD STE 220
City ORLANDO
State FL
ZIP 32827
Phone 407 930-7801
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2025
Certificate Expiration Date 1/5/2027
Facility Type Physician Office
Lab Director AMIT DESAI

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