10D2262655 CLIA NUMBER - WOMENS HEALTH 360

Laboratory Demographics

CLIA Number: 10D2262655

Facility Name: WOMENS HEALTH 360

Facility Address:
6009 S ORANGE AVE UNIT #6017
ORLANDO, FL
ZIP 32809
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Facility Phone Number: 407 986-3553

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1336870484

Taxonomy: 363LX0001X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	10D2262655
LAB Type	Practitioner Other
Facility Name	WOMENS HEALTH 360
Street	6009 S ORANGE AVE UNIT #6017
City	ORLANDO
State	FL
ZIP	32809
Phone	407 986-3553
CertificateType	4
CertificateEffectiveDate	6/16/2022
CertificateExpirationDate	6/15/2024
FacilityType	Waiver

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