10D2278306 CLIA NUMBER - VIDA HEALTH CENTRE LLC

Laboratory Demographics

CLIA Number: 10D2278306

Facility Name: VIDA HEALTH CENTRE LLC

Facility Address:
5979 VINELAND ROAD SUITE 209
ORLANDO, FL
ZIP 32819
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Facility Phone Number: 407 250-5030

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1346953924

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	10D2278306
LAB Type	Physician Office
Facility Name	VIDA HEALTH CENTRE LLC
Street	5979 VINELAND ROAD SUITE 209
City	ORLANDO
State	FL
ZIP	32819
Phone	407 250-5030
CertificateType	4
CertificateEffectiveDate	3/15/2023
CertificateExpirationDate	3/14/2025
FacilityType	Waiver

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