10D2179044 CLIA NUMBER - ORLANDO PHYSICIAN NETWORK

Laboratory Demographics

  • CLIA Code: 10D2179044
  • Facility Name: ORLANDO PHYSICIAN NETWORK
  • Facility Address: 931 NORTH SR 434
    ALTAMONTE SPRINGS, FL
    ZIP 32714
  • Facility Phone: 407 635-5514
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THOMAS KELLEY
  • NPI Number: 1255005567
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2179044
LAB Type Physician Office
Facility Name ORLANDO PHYSICIAN NETWORK
Street 931 NORTH SR 434
City ALTAMONTE SPRINGS
State FL
ZIP 32714
Phone 407 635-5514
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Physician Office
Lab Director THOMAS KELLEY

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