10D2145007 CLIA NUMBER - MEDICAL CENTRAL, LLC

Laboratory Demographics

CLIA Number: 10D2145007

Facility Name: MEDICAL CENTRAL, LLC

Facility Address:
114 DEL PRADO BLVD S - STE 100
CAPE CORAL, FL
ZIP 33990
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Facility Phone Number: 239 471-2874

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1134628951

Taxonomy: 261QM0801X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2145007
LAB Type	Physician Office
Facility Name	MEDICAL CENTRAL, LLC
Street	114 DEL PRADO BLVD S - STE 100
City	CAPE CORAL
State	FL
ZIP	33990
Phone	239 471-2874
CertificateType	4
CertificateEffectiveDate	2/27/2024
CertificateExpirationDate	2/26/2026
FacilityType	Waiver

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