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10D0952463 CLIA NUMBER - NEPHROLOGY CONSULTANTS OF SO FL PA ROBERTO P COQUIS MD/J FERNANDO QUINTERO MD

Laboratory Demographics

CLIA Number: 10D0952463

Facility Name: NEPHROLOGY CONSULTANTS OF SO FL PA ROBERTO P COQUIS MD/J FERNANDO QUINTERO MD

Facility Address:
2161 E COMMERCIAL BLVD 2ND FL
FORT LAUDERDALE, FL
ZIP 33308
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Facility Phone Number: 954 491-5187

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1043260284

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name Field Value
CLIA Number 10D0952463
LAB Type Physician Office
Facility Name NEPHROLOGY CONSULTANTS OF SO FL PA ROBERTO P COQUIS MD/J FERNANDO QUINTERO MD
Street 2161 E COMMERCIAL BLVD 2ND FL
City FORT LAUDERDALE
State FL
ZIP 33308
Phone 954 491-5187
CertificateType 4
CertificateEffectiveDate 10/14/2022
CertificateExpirationDate 10/13/2024
FacilityType Waiver

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