10D2292523 CLIA NUMBER - WALKING TREE FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 10D2292523
  • Facility Name: WALKING TREE FAMILY PRACTICE
  • Facility Address: 3098 W LAKE MARY BOULEVARD
    LAKE MARY, FL
    ZIP 32746
  • Facility Phone: 407 807-7248
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BESSIE J. FAIRBARIN
  • NPI Number: 1194502021
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2292523
LAB Type Physician Office
Facility Name WALKING TREE FAMILY PRACTICE
Street 3098 W LAKE MARY BOULEVARD
City LAKE MARY
State FL
ZIP 32746
Phone 407 807-7248
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2023
Certificate Expiration Date 10/25/2025
Facility Type Physician Office
Lab Director BESSIE J. FAIRBARIN

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