10D2121650 CLIA NUMBER - ADVANTAGE MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 10D2121650
  • Facility Name: ADVANTAGE MEDICAL GROUP
  • Facility Address: 715 E VINE ST STE 1
    KISSIMMEE, FL
    ZIP 34744
  • Facility Phone: 407 930-1112
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELLY BENZAQUEN PARKES
  • NPI Number: 1841718327
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 10D2121650
LAB Type Physician Office
Facility Name ADVANTAGE MEDICAL GROUP
Street 715 E VINE ST STE 1
City KISSIMMEE
State FL
ZIP 34744
Phone 407 930-1112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/10/2024
Certificate Expiration Date 11/9/2026
Facility Type Physician Office
Lab Director ELLY BENZAQUEN PARKES

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