10D2317598 CLIA NUMBER - ISA MEDICAL CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D2317598
  • Facility Name: ISA MEDICAL CENTER LLC
  • Facility Address: 9350 W US 192 HWY
    DAVENPORT, FL
    ZIP 33897
  • Facility Phone: 407 209-5451
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MINELY B. MARTINEZ VELAZQUEZ
  • NPI Number: 1568279255
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2317598
LAB Type Physician Office
Facility Name ISA MEDICAL CENTER LLC
Street 9350 W US 192 HWY
City DAVENPORT
State FL
ZIP 33897
Phone 407 209-5451
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2025
Certificate Expiration Date 1/27/2027
Facility Type Physician Office
Lab Director MINELY B. MARTINEZ VELAZQUEZ

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