10D2240604 CLIA NUMBER - MG MEDICINE LLC

Laboratory Demographics

  • CLIA Code: 10D2240604
  • Facility Name: MG MEDICINE LLC
  • Facility Address: 1213 N CENTRAL AVE
    KISSIMMEE, FL
    ZIP 34741
  • Facility Phone: 407 483-4795
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MELANIE MELENDEZ-GARCIA
  • NPI Number: 1083384655
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2240604
LAB Type Physician Office
Facility Name MG MEDICINE LLC
Street 1213 N CENTRAL AVE
City KISSIMMEE
State FL
ZIP 34741
Phone 407 483-4795
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/20/2023
Certificate Expiration Date 10/19/2025
Facility Type Physician Office
Lab Director MELANIE MELENDEZ-GARCIA

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