10D2328729 CLIA NUMBER - KP PPEC LLC

Laboratory Demographics

  • CLIA Code: 10D2328729
  • Facility Name: KP PPEC LLC
  • Facility Address: 12200 MENTA ST STE 105
    ORLANDO, FL
    ZIP 32837
  • Facility Phone: 407 455-1739
  • Facility Type: Other - PPEC
  • Facility Type: Waiver
  • Lab Director: MARTIN LUGO
  • NPI Number: 1144109984
  • Taxonomy: 261QM3000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2328729
LAB Type Other - PPEC
Facility Name KP PPEC LLC
Street 12200 MENTA ST STE 105
City ORLANDO
State FL
ZIP 32837
Phone 407 455-1739
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2025
Certificate Expiration Date 8/14/2027
Facility Type Other - PPEC
Lab Director MARTIN LUGO

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