10D1025088 CLIA NUMBER - VANGUARD MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 10D1025088
  • Facility Name: VANGUARD MEDICAL GROUP
  • Facility Address: 1601 PALM AVE SUITE 101
    PEMBROKE PINES, FL
    ZIP 33026
  • Facility Phone: 954 436-6660
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MIAN A. HASAN
  • NPI Number: 1346761392
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D1025088
LAB Type Physician Office
Facility Name VANGUARD MEDICAL GROUP
Street 1601 PALM AVE SUITE 101
City PEMBROKE PINES
State FL
ZIP 33026
Phone 954 436-6660
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2024
Certificate Expiration Date 4/27/2026
Facility Type Physician Office
Lab Director MIAN A. HASAN

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