10D2159308 CLIA NUMBER - ORLANDO PHYSICIAN NETWORK

Laboratory Demographics

  • CLIA Code: 10D2159308
  • Facility Name: ORLANDO PHYSICIAN NETWORK
  • Facility Address: 109 BUENAVENTURA BLVD
    KISSIMMEE, FL
    ZIP 34743
  • Facility Phone: 407 649-7413
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NEASHA MERRITT
  • NPI Number: 1316610868
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2159308
LAB Type Physician Office
Facility Name ORLANDO PHYSICIAN NETWORK
Street 109 BUENAVENTURA BLVD
City KISSIMMEE
State FL
ZIP 34743
Phone 407 649-7413
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Physician Office
Lab Director NEASHA MERRITT

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