10D2095263 CLIA NUMBER - PRIMEOBGYN ORLANDO LLC

Laboratory Demographics

  • CLIA Code: 10D2095263
  • Facility Name: PRIMEOBGYN ORLANDO LLC
  • Facility Address: 1111 S ORANGE AVE
    ORLANDO, FL
    ZIP 32806
  • Facility Phone: 561 300-2410
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MATTHEW MERVIS
  • NPI Number: 1730428020
  • Taxonomy: 174400000X - Specialist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2095263
LAB Type Physician Office
Facility Name PRIMEOBGYN ORLANDO LLC
Street 1111 S ORANGE AVE
City ORLANDO
State FL
ZIP 32806
Phone 561 300-2410
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 5/5/2025
Certificate Expiration Date 5/4/2027
Facility Type Physician Office
Lab Director MATTHEW MERVIS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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