10D2191281 CLIA NUMBER - ORLANDO PHYSICIAN NETWORK

Laboratory Demographics

  • CLIA Code: 10D2191281
  • Facility Name: ORLANDO PHYSICIAN NETWORK
  • Facility Address: 4401 S ORANGE AVE STE 108
    ORLANDO, FL
    ZIP 32806
  • Facility Phone: 407 649-7413
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HAZEL ANN M. DAVID
  • NPI Number: 1811660202
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2191281
LAB Type Physician Office
Facility Name ORLANDO PHYSICIAN NETWORK
Street 4401 S ORANGE AVE STE 108
City ORLANDO
State FL
ZIP 32806
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 8/25/2024
Certificate Expiration Date 8/24/2026
Facility Type Physician Office
Lab Director HAZEL ANN M. DAVID

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