10D2118524 CLIA NUMBER - NORTHWEST FAMILY HEALTH CENTER, LLC

Laboratory Demographics

CLIA Number: 10D2118524

Facility Name: NORTHWEST FAMILY HEALTH CENTER, LLC

Facility Address:
5844 NORTH ORANGE BLOSSOM TRAIL
ORLANDO, FL
ZIP 32810
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Facility Phone Number: 407 602-1100

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1942824578

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2118524
LAB Type	Physician Office
Facility Name	NORTHWEST FAMILY HEALTH CENTER, LLC
Street	5844 NORTH ORANGE BLOSSOM TRAIL
City	ORLANDO
State	FL
ZIP	32810
Phone	407 602-1100
CertificateType	4
CertificateEffectiveDate	10/6/2023
CertificateExpirationDate	10/5/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024