10D2190657 CLIA NUMBER - ORLANDO PHYSICIAN NETWORK

Laboratory Demographics

  • CLIA Code: 10D2190657
  • Facility Name: ORLANDO PHYSICIAN NETWORK
  • Facility Address: 800 N MAITLAND AVE SUITE101
    MAITLAND, FL
    ZIP 32751
  • Facility Phone: 407 649-7413
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BORIS E. CORONADO
  • NPI Number: 1033883335
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2190657
LAB Type Physician Office
Facility Name ORLANDO PHYSICIAN NETWORK
Street 800 N MAITLAND AVE SUITE101
City MAITLAND
State FL
ZIP 32751
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 8/18/2024
Certificate Expiration Date 8/17/2026
Facility Type Physician Office
Lab Director BORIS E. CORONADO

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