10D0024301 CLIA NUMBER - JACKSON MEMORIAL HOSPITAL CLINICAL LABORATORY

Laboratory Demographics

CLIA Number: 10D0024301

Facility Name: JACKSON MEMORIAL HOSPITAL CLINICAL LABORATORY

Facility Address:
1611 NW 12TH AVENUE
MIAMI, FL
ZIP 33136
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Facility Phone Number: 305 585-6210

Facility Type: Hospital

Certificate Type: Accreditation

NPI Number: 1588737191

Taxonomy: 282NC0060X - General Acute Care Hospital

CLIA Record

Field Name	Field Value
CLIA Number	10D0024301
LAB Type	Hospital
Facility Name	JACKSON MEMORIAL HOSPITAL CLINICAL LABORATORY
Street	1611 NW 12TH AVENUE
City	MIAMI
State	FL
ZIP	33136
Phone	305 585-6210
CertificateType	1
CertificateEffectiveDate	2/28/2023
CertificateExpirationDate	2/27/2025
FacilityType	Accreditation

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