10D2190398 CLIA NUMBER - OURHEALTH PROFESSIONAL PHYSICIAN GROUP LLC

Laboratory Demographics

  • CLIA Code: 10D2190398
  • Facility Name: OURHEALTH PROFESSIONAL PHYSICIAN GROUP LLC
  • Facility Address: 6277 SEA HARBOR DRIVE
    ORLANDO, FL
    ZIP 32821
  • Facility Phone: 689 210-0525
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JUSTINE KURODA
  • NPI Number: 1740804566
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2190398
LAB Type Physician Office
Facility Name OURHEALTH PROFESSIONAL PHYSICIAN GROUP LLC
Street 6277 SEA HARBOR DRIVE
City ORLANDO
State FL
ZIP 32821
Phone 689 210-0525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/13/2024
Certificate Expiration Date 8/12/2026
Facility Type Physician Office
Lab Director JUSTINE KURODA

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