10D0725384 CLIA NUMBER - PALM MEDICAL CENTER HIALEAH LLC

Laboratory Demographics

CLIA Number: 10D0725384

Facility Name: PALM MEDICAL CENTER HIALEAH LLC

Facility Address:
1401 E 4TH AVENUE #104
HIALEAH, FL
ZIP 33010
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Facility Phone Number: 305 888-9000

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1306347661

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D0725384
LAB Type	Physician Office
Facility Name	PALM MEDICAL CENTER HIALEAH LLC
Street	1401 E 4TH AVENUE #104
City	HIALEAH
State	FL
ZIP	33010
Phone	305 888-9000
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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