10D2264034 CLIA NUMBER - CHAIN OF LAKES PRIMARY CARE, LLC

Laboratory Demographics

CLIA Number: 10D2264034

Facility Name: CHAIN OF LAKES PRIMARY CARE, LLC

Facility Address:
8976 CONROY WINDERMERE ROAD
ORLANDO, FL
ZIP 32835
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Facility Phone Number: 407 494-0770

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1740912534

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 10D2264034
LAB Type Physician Office
Facility Name CHAIN OF LAKES PRIMARY CARE, LLC
Street 8976 CONROY WINDERMERE ROAD
City ORLANDO
State FL
ZIP 32835
Phone 407 494-0770
CertificateType 4
CertificateEffectiveDate 7/8/2022
CertificateExpirationDate 7/7/2024
FacilityType Waiver

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