10D1071734 CLIA NUMBER - BRISEIDA CASTA MD PA

Laboratory Demographics

  • CLIA Code: 10D1071734
  • Facility Name: BRISEIDA CASTA MD PA
  • Facility Address: 2731 EXECUTIVE PARK DR STE 3
    WESTON, FL
    ZIP 33331
  • Facility Phone: 954 389-1064
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRISEIDA CASTA MD
  • NPI Number: 1376531566
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D1071734
LAB Type Physician Office
Facility Name BRISEIDA CASTA MD PA
Street 2731 EXECUTIVE PARK DR STE 3
City WESTON
State FL
ZIP 33331
Phone 954 389-1064
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/31/2023
Certificate Expiration Date 7/30/2025
Facility Type Physician Office
Lab Director BRISEIDA CASTA MD

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This page was last updated on: 6/4/2025