10D2226880 CLIA NUMBER - MID FLORIDA DERMATOLOGY & PLASTIC SURGERY

Laboratory Demographics

  • CLIA Code: 10D2226880
  • Facility Name: MID FLORIDA DERMATOLOGY & PLASTIC SURGERY
  • Facility Address: 2302 NORTH BLVD WEST STE A
    DAVENPORT, FL
    ZIP 33837
  • Facility Phone: 863 422-5355
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: RAYMOND R. KNISLEY
  • NPI Number: 1548573488
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 10D2226880
LAB Type Physician Office
Facility Name MID FLORIDA DERMATOLOGY & PLASTIC SURGERY
Street 2302 NORTH BLVD WEST STE A
City DAVENPORT
State FL
ZIP 33837
Phone 863 422-5355
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 2/10/2024
Certificate Expiration Date 2/9/2026
Facility Type Physician Office
Lab Director RAYMOND R. KNISLEY

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