10D1107131 CLIA NUMBER - LAKESIDE MEDICAL, LLC

Laboratory Demographics

  • CLIA Code: 10D1107131
  • Facility Name: LAKESIDE MEDICAL, LLC
  • Facility Address: 600 N HIATUS RD STE 203
    PEMBROKE PINES, FL
    ZIP 33026
  • Facility Phone: (954) 392-7157
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ARMANDO A. DEFERIA
  • NPI Number: 1356820286
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1107131
LAB Type Physician Office
Facility Name LAKESIDE MEDICAL, LLC
Street 600 N HIATUS RD STE 203
City PEMBROKE PINES
State FL
ZIP 33026
Phone 9543927157
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2025
Certificate Expiration Date 10/27/2027
Facility Type Physician Office
Lab Director ARMANDO A. DEFERIA

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This page was last updated on: 5/15/2026