10D1022448 CLIA NUMBER - MARIO J FONSECA MD PA

Laboratory Demographics

  • CLIA Code: 10D1022448
  • Facility Name: MARIO J FONSECA MD PA
  • Facility Address: 7325 SW 63 AVE, STE 201
    MIAMI, FL
    ZIP 33143
  • Facility Phone: 305 669-9404
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARIO J. FONSECA
  • NPI Number: 1124082003
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1022448
LAB Type Physician Office
Facility Name MARIO J FONSECA MD PA
Street 7325 SW 63 AVE, STE 201
City MIAMI
State FL
ZIP 33143
Phone 305 669-9404
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2024
Certificate Expiration Date 2/16/2026
Facility Type Physician Office
Lab Director MARIO J. FONSECA

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