10D0926890 CLIA NUMBER - CAMILLUS HEALTH CONCERN INC

Laboratory Demographics

CLIA Number: 10D0926890

Facility Name: CAMILLUS HEALTH CONCERN INC

Facility Address:
336 NW 5TH ST
MIAMI, FL
ZIP 33128
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Facility Phone Number: 305 577-4840

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1659536365

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0926890
LAB Type	Federally Qualified Health Center
Facility Name	CAMILLUS HEALTH CONCERN INC
Street	336 NW 5TH ST
City	MIAMI
State	FL
ZIP	33128
Phone	305 577-4840
CertificateType	4
CertificateEffectiveDate	10/5/2023
CertificateExpirationDate	10/4/2025
FacilityType	Waiver

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