10D2282527 CLIA NUMBER - CENTRAL PARK WELLNESS CLINIC INC

Laboratory Demographics

CLIA Number: 10D2282527

Facility Name: CENTRAL PARK WELLNESS CLINIC INC

Facility Address:
1713 W OAK RIDGE RD
ORLANDO, FL
ZIP 32809
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Facility Phone Number: 407 580-5453

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1356027221

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D2282527
LAB Type	Practitioner Other
Facility Name	CENTRAL PARK WELLNESS CLINIC INC
Street	1713 W OAK RIDGE RD
City	ORLANDO
State	FL
ZIP	32809
Phone	407 580-5453
CertificateType	4
CertificateEffectiveDate	5/23/2023
CertificateExpirationDate	5/22/2025
FacilityType	Waiver

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