10D2272149 CLIA NUMBER - VIDA PLUS MEDICAL LLC

Laboratory Demographics

  • CLIA Code: 10D2272149
  • Facility Name: VIDA PLUS MEDICAL LLC
  • Facility Address: 339 CYPRESS PKWY SUITE 270
    KISSIMMEE, FL
    ZIP 34759
  • Facility Phone: 407 910-1555
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EDWIN NIEVEZ HERNANDEZ
  • NPI Number: 1992424832
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 10D2272149
LAB Type Physician Office
Facility Name VIDA PLUS MEDICAL LLC
Street 339 CYPRESS PKWY SUITE 270
City KISSIMMEE
State FL
ZIP 34759
Phone 407 910-1555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2024
Certificate Expiration Date 11/14/2026
Facility Type Physician Office
Lab Director EDWIN NIEVEZ HERNANDEZ

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