10D1107124 CLIA NUMBER - SOUTH FLORIDA JAW & FACIAL SURGERY

Laboratory Demographics

  • CLIA Code: 10D1107124
  • Facility Name: SOUTH FLORIDA JAW & FACIAL SURGERY
  • Facility Address: 7600 S RED RD STE 101
    MIAMI, FL
    ZIP 33143
  • Facility Phone: 305 661-5297
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: KROUM D. DIMITROV
  • NPI Number: 1710921036
  • Taxonomy: 1223S0112X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 10D1107124
LAB Type Practitioner Other
Facility Name SOUTH FLORIDA JAW & FACIAL SURGERY
Street 7600 S RED RD STE 101
City MIAMI
State FL
ZIP 33143
Phone 305 661-5297
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2023
Certificate Expiration Date 10/27/2025
Facility Type Practitioner Other
Lab Director KROUM D. DIMITROV

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