10D2301752 CLIA NUMBER - EVERNORTH CARE PROVIDERS - TENNESSEE PC CORPORATION

Laboratory Demographics

  • CLIA Code: 10D2301752
  • Facility Name: EVERNORTH CARE PROVIDERS - TENNESSEE PC CORPORATION
  • Facility Address: 4700 MILLENIA BLVD, SUITE 500, 5TH FLOOR
    ORLANDO, FL
    ZIP 32839
  • Facility Phone: 877 663-1333
  • Facility Type: Other - IN-HOME PRIMARY CARE
  • Facility Type: Waiver
  • Lab Director: STEPHEN WALSH
  • NPI Number: 1316726730
  • Taxonomy: 208D00000X - General Practice

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2301752
LAB Type Other - IN-HOME PRIMARY CARE
Facility Name EVERNORTH CARE PROVIDERS - TENNESSEE PC CORPORATION
Street 4700 MILLENIA BLVD, SUITE 500, 5TH FLOOR
City ORLANDO
State FL
ZIP 32839
Phone 877 663-1333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2024
Certificate Expiration Date 3/31/2026
Facility Type Other - IN-HOME PRIMARY CARE
Lab Director STEPHEN WALSH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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