10D1031679 CLIA NUMBER - MEMORIAL PRIMARY CARE - HALLANDALE

Laboratory Demographics

  • CLIA Code: 10D1031679
  • Facility Name: MEMORIAL PRIMARY CARE - HALLANDALE
  • Facility Address: 1750 E HALLANDALE BEACH BLVD
    HALLANDALE, FL
    ZIP 33009
  • Facility Phone: 954 276-9700
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAURA C. WEAVER LONDON
  • NPI Number: 1073885042
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 10D1031679
LAB Type Physician Office
Facility Name MEMORIAL PRIMARY CARE - HALLANDALE
Street 1750 E HALLANDALE BEACH BLVD
City HALLANDALE
State FL
ZIP 33009
Phone 954 276-9700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/7/2024
Certificate Expiration Date 10/6/2026
Facility Type Physician Office
Lab Director LAURA C. WEAVER LONDON

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