10D2113609 CLIA NUMBER - MANA MEDICAL GROUP LLC DBA MANA SPINE

Laboratory Demographics

  • CLIA Code: 10D2113609
  • Facility Name: MANA MEDICAL GROUP LLC DBA MANA SPINE
  • Facility Address: 1502 N DONNELLY ST #107
    MOUNT DORA, FL
    ZIP 32757
  • Facility Phone: 407 605-5621
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AVI BHANDARY
  • NPI Number: 1649656331
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2113609
LAB Type Physician Office
Facility Name MANA MEDICAL GROUP LLC DBA MANA SPINE
Street 1502 N DONNELLY ST #107
City MOUNT DORA
State FL
ZIP 32757
Phone 407 605-5621
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2024
Certificate Expiration Date 5/24/2026
Facility Type Physician Office
Lab Director AVI BHANDARY

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