10D0992417 CLIA NUMBER - ANITA L PETTEWAY MD

Laboratory Demographics

  • CLIA Code: 10D0992417
  • Facility Name: ANITA L PETTEWAY MD
  • Facility Address: 150 NW 168TH STREET SUITE 301
    NORTH MIAMI BEACH, FL
    ZIP 33169
  • Facility Phone: 305 944-8887
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANITA L. PETTEWAY
  • NPI Number: 1407045644
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0992417
LAB Type Physician Office
Facility Name ANITA L PETTEWAY MD
Street 150 NW 168TH STREET SUITE 301
City NORTH MIAMI BEACH
State FL
ZIP 33169
Phone 305 944-8887
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/16/2023
Certificate Expiration Date 10/15/2025
Facility Type Physician Office
Lab Director ANITA L. PETTEWAY

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