10D1048271 CLIA NUMBER - EMILIO JUNCOSA MD

Laboratory Demographics

CLIA Number: 10D1048271

Facility Name: EMILIO JUNCOSA MD

Facility Address:
1741 NW 123 AVE
PEMBROKE PINES, FL
ZIP 33026
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Facility Phone Number: 954 441-9595

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1568485969

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	10D1048271
LAB Type	Physician Office
Facility Name	EMILIO JUNCOSA MD
Street	1741 NW 123 AVE
City	PEMBROKE PINES
State	FL
ZIP	33026
Phone	954 441-9595
CertificateType	4
CertificateEffectiveDate	11/29/2023
CertificateExpirationDate	11/28/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024