10D0948013 CLIA NUMBER - JORGE TRAVIESO MD

Laboratory Demographics

CLIA Number: 10D0948013

Facility Name: JORGE TRAVIESO MD

Facility Address:
2369 W 52ND STREET
HIALEAH, FL
ZIP 33016
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Facility Phone Number: 305 825-0587

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1144398157

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D0948013
LAB Type	Physician Office
Facility Name	JORGE TRAVIESO MD
Street	2369 W 52ND STREET
City	HIALEAH
State	FL
ZIP	33016
Phone	305 825-0587
CertificateType	4
CertificateEffectiveDate	6/30/2022
CertificateExpirationDate	6/29/2024
FacilityType	Waiver

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