10D0976999 CLIA NUMBER - LUIS J VICTORES GASTROENTEROLOGY LLC

Laboratory Demographics

CLIA Number: 10D0976999

Facility Name: LUIS J VICTORES GASTROENTEROLOGY LLC

Facility Address:
315 A WEST 49TH STREET
HIALEAH, FL
ZIP 33012
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Facility Phone Number: 305 820-4426

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1952330508

Taxonomy: 207RG0100X - Internal Medicine
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

CLIA Record

Field Name	Field Value
CLIA Number	10D0976999
LAB Type	Physician Office
Facility Name	LUIS J VICTORES GASTROENTEROLOGY LLC
Street	315 A WEST 49TH STREET
City	HIALEAH
State	FL
ZIP	33012
Phone	305 820-4426
CertificateType	4
CertificateEffectiveDate	8/17/2022
CertificateExpirationDate	8/16/2024
FacilityType	Waiver

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