10D2159308 CLIA NUMBER - ORLANDO PHYSICIAN NETWORK

Laboratory Demographics

CLIA Number: 10D2159308

Facility Name: ORLANDO PHYSICIAN NETWORK

Facility Address:
104 BUENAVENTURA BLVD
KISSIMMEE, FL
ZIP 34743
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Facility Phone Number: 407 891-2947

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1316610868

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D2159308
LAB Type	Physician Office
Facility Name	ORLANDO PHYSICIAN NETWORK
Street	104 BUENAVENTURA BLVD
City	KISSIMMEE
State	FL
ZIP	34743
Phone	407 891-2947
CertificateType	4
CertificateEffectiveDate	12/17/2022
CertificateExpirationDate	12/16/2024
FacilityType	Waiver

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