10D0857208 CLIA NUMBER - MARIO N FAVILLI MD PA

Laboratory Demographics

  • CLIA Code: 10D0857208
  • Facility Name: MARIO N FAVILLI MD PA
  • Facility Address: 4855 W HILLSBORO BLVD STE B 8
    COCONUT CREEK, FL
    ZIP 33073
  • Facility Phone: 954 481-2278
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARIO N. FAVILLI
  • NPI Number: 1730304221
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0857208
LAB Type Physician Office
Facility Name MARIO N FAVILLI MD PA
Street 4855 W HILLSBORO BLVD STE B 8
City COCONUT CREEK
State FL
ZIP 33073
Phone 954 481-2278
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/12/2025
Certificate Expiration Date 9/11/2027
Facility Type Physician Office
Lab Director MARIO N. FAVILLI

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