10D2266432 CLIA NUMBER - UPPERLINE HEALTHCARE PROFESSIONAL CORPORATION

Laboratory Demographics

CLIA Number: 10D2266432

Facility Name: UPPERLINE HEALTHCARE PROFESSIONAL CORPORATION

Facility Address:
2111 GLENWOOD DRIVE STE 208
WINTER PARK, FL
ZIP 32792
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Facility Phone Number: 407 919-6202

Facility Type: Other - VASCULAR OUTPATIENT LAB

Certificate Type: Waiver

NPI Number: 1073197414

Taxonomy: 213ES0131X - Podiatrist

CLIA Record

Field Name	Field Value
CLIA Number	10D2266432
LAB Type	Other - VASCULAR OUTPATIENT LAB
Facility Name	UPPERLINE HEALTHCARE PROFESSIONAL CORPORATION
Street	2111 GLENWOOD DRIVE STE 208
City	WINTER PARK
State	FL
ZIP	32792
Phone	407 919-6202
CertificateType	4
CertificateEffectiveDate	8/10/2022
CertificateExpirationDate	8/9/2024
FacilityType	Waiver

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