10D2214054 CLIA NUMBER - CENTER FOR LIVING WELL - CELEBRATION

Laboratory Demographics

CLIA Number: 10D2214054

Facility Name: CENTER FOR LIVING WELL - CELEBRATION

Facility Address:
1530 CELEBRATION BLVD SUITE 100RX
KISSIMMEE, FL
ZIP 34747
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Facility Phone Number: 321 939-2579

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1083811772

Taxonomy: 207RG0100X - Internal Medicine
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

CLIA Record

Field Name	Field Value
CLIA Number	10D2214054
LAB Type	Pharmacy
Facility Name	CENTER FOR LIVING WELL - CELEBRATION
Street	1530 CELEBRATION BLVD SUITE 100RX
City	KISSIMMEE
State	FL
ZIP	34747
Phone	321 939-2579
CertificateType	4
CertificateEffectiveDate	2/18/2023
CertificateExpirationDate	2/17/2025
FacilityType	Waiver

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