10D2257054 CLIA NUMBER - D & D PRIMARY CARE LLC

Laboratory Demographics

  • CLIA Code: 10D2257054
  • Facility Name: D & D PRIMARY CARE LLC
  • Facility Address: 844 N JOHN YOUNG PKWY
    KISSIMMEE, FL
    ZIP 34741
  • Facility Phone: 407 795-7705
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DARLENE V. GORDON
  • NPI Number: 1831611375
  • Taxonomy: 363LC1500X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2257054
LAB Type Practitioner Other
Facility Name D & D PRIMARY CARE LLC
Street 844 N JOHN YOUNG PKWY
City KISSIMMEE
State FL
ZIP 34741
Phone 407 795-7705
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2024
Certificate Expiration Date 3/30/2026
Facility Type Practitioner Other
Lab Director DARLENE V. GORDON

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