10D2004027 CLIA NUMBER - MAGI HEALTH CARE CLINIC INC

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Laboratory Demographics

CLIA Number: 10D2004027

Facility Name: MAGI HEALTH CARE CLINIC INC

Facility Address:
5803 NW 151ST SUITE #'S 301-303-305-307
MIAMI LAKES, FL
ZIP 33014
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Facility Phone Number: 786 422-7374

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1609184407

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2004027
LAB Type	Physician Office
Facility Name	MAGI HEALTH CARE CLINIC INC
Street	5803 NW 151ST SUITE #'S 301-303-305-307
City	MIAMI LAKES
State	FL
ZIP	33014
Phone	786 422-7374
CertificateType	4
CertificateEffectiveDate	2/24/2024
CertificateExpirationDate	2/23/2026
FacilityType	Waiver

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