10D2301328 CLIA NUMBER - ADVENTHEALTH MEDICAL GROUP INFLAMMATORY BOWEL DISEASE CLINIC AT ORLANDO

Laboratory Demographics

CLIA Number: 10D2301328

Facility Name: ADVENTHEALTH MEDICAL GROUP INFLAMMATORY BOWEL DISEASE CLINIC AT ORLANDO

Facility Address:
2415 N ORANGE AVE STE 200
ORLANDO, FL
ZIP 32804
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Facility Phone Number: 407 303-9921

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1942389747

Taxonomy: 2085R0202X - Radiology
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

CLIA Record

Field Name	Field Value
CLIA Number	10D2301328
LAB Type	Physician Office
Facility Name	ADVENTHEALTH MEDICAL GROUP INFLAMMATORY BOWEL DISEASE CLINIC AT ORLANDO
Street	2415 N ORANGE AVE STE 200
City	ORLANDO
State	FL
ZIP	32804
Phone	407 303-9921
CertificateType	4
CertificateEffectiveDate	3/25/2024
CertificateExpirationDate	3/24/2026
FacilityType	Waiver

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