10D0672028 CLIA NUMBER - TORY SULLIVAN MD PA

Laboratory Demographics

  • CLIA Code: 10D0672028
  • Facility Name: TORY SULLIVAN MD PA
  • Facility Address: 16100 NE 16TH AVE STE A
    NORTH MIAMI BEACH, FL
    ZIP 33162
  • Facility Phone: 305 652-8600
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. TORY P. SULLIVAN
  • NPI Number: 1639137169
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 10D0672028
LAB Type Physician Office
Facility Name TORY SULLIVAN MD PA
Street 16100 NE 16TH AVE STE A
City NORTH MIAMI BEACH
State FL
ZIP 33162
Phone 305 652-8600
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/6/2024
Certificate Expiration Date 9/5/2026
Facility Type Physician Office
Lab Director DR. TORY P. SULLIVAN

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