CLIA lab
CLIA 10D2165204: Conviva Medical Center Management LLC
Port Orange, FL. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 10D2165204 belongs to Conviva Medical Center Management LLC in Port Orange, FL.
Certificate of Waiver, effective April 23, 2025, expires April 22, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- April 23, 2025
- Certificate expiration
- April 22, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- April 23, 2019
- Facility type
- Physician office
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 10D2165204
- Lab name
- Conviva Medical Center Management LLC
- Additional name
- DBA Conviva Care Center
- Address
- 4090 S Ridgewood Avenue, Port Orange, FL 32127
- Phone
- (386) 308-7900
- Fax
- (855) 569-3050
Annual test volume the lab reported
- Waived tests
- 800
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Port Orange, FL
- Advanced Cardiology/Ashraf Elsakr MDCertificate of Waiver, Physician office10D0970293
- Advanced Dermatology and Cosmetic SurgeryCertificate of Accreditation, Physician office10D2158831
- Advanced Medical Research Center LLCCertificate of Waiver, Other10D1102355
- Advanced Urology InstituteCertificate of Waiver, Physician office10D2233909
- Adventhealh Medical GroupCertificate of Waiver, Physician office10D2326896
- Adventhealth Centra Care Port OrangeCertificate of Waiver, Other10D2078154
- Adventhealth Imaging Center Port OrangeCertificate of Waiver, Physician office10D2269619
- Adventhealth LabCertificate of Accreditation, Hospital10D2221079
- Adventhealth LabCertificate of Waiver, Hospital10D2221089
- Adventhealth Medical GroupCertificate of Waiver, Physician office10D2338760
Related
Questions
What is the CLIA number for Conviva Medical Center Management LLC in Port Orange?
10D2165204, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Conviva Medical Center Management LLC hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 10D2165204 expire?
The CMS file lists April 22, 2027 as the certificate expiration date; the certificate took effect April 23, 2025.