10D2266542 CLIA NUMBER - ORANGE AVENUE SURGERY CENTER, LLC

Laboratory Demographics

  • CLIA Code: 10D2266542
  • Facility Name: ORANGE AVENUE SURGERY CENTER, LLC
  • Facility Address: 1405 SOUTH ORANGE AVENUE, SUITE 120
    ORLANDO, FL
    ZIP 32806
  • Facility Phone: 321 228-6700
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JORGE E. HERNANDEZ
  • NPI Number: 1790442895
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2266542
LAB Type Ambulatory Surgery Center
Facility Name ORANGE AVENUE SURGERY CENTER, LLC
Street 1405 SOUTH ORANGE AVENUE, SUITE 120
City ORLANDO
State FL
ZIP 32806
Phone 321 228-6700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2024
Certificate Expiration Date 8/10/2026
Facility Type Ambulatory Surgery Center
Lab Director JORGE E. HERNANDEZ

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