10D2235271 CLIA NUMBER - VIDA MEDICAL CLINIC LLC

Laboratory Demographics

  • CLIA Code: 10D2235271
  • Facility Name: VIDA MEDICAL CLINIC LLC
  • Facility Address: 7550 FUTURES DRIVE SUITE 104
    ORLANDO, FL
    ZIP 32819
  • Facility Phone: 407 978-6400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CARLOS J. LUGO
  • NPI Number: 1356967475
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 10D2235271
LAB Type Physician Office
Facility Name VIDA MEDICAL CLINIC LLC
Street 7550 FUTURES DRIVE SUITE 104
City ORLANDO
State FL
ZIP 32819
Phone 407 978-6400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2023
Certificate Expiration Date 9/7/2025
Facility Type Physician Office
Lab Director CARLOS J. LUGO

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This page was last updated on: 3/20/2025