10D1033644 CLIA NUMBER - JACKSON MEDICAL GROUP SOUTH BEACH

Laboratory Demographics

  • CLIA Code: 10D1033644
  • Facility Name: JACKSON MEDICAL GROUP SOUTH BEACH
  • Facility Address: 615 COLLINS AVENUE
    MIAMI BEACH, FL
    ZIP 33139
  • Facility Phone: 305 585-4200
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: ROBERTO R. GONZALEZ
  • NPI Number: 1336152073
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 10D1033644
LAB Type Other
Facility Name JACKSON MEDICAL GROUP SOUTH BEACH
Street 615 COLLINS AVENUE
City MIAMI BEACH
State FL
ZIP 33139
Phone 305 585-4200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2024
Certificate Expiration Date 11/14/2026
Facility Type Other
Lab Director ROBERTO R. GONZALEZ

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