10D2004848 CLIA NUMBER - IVAN CASTANO MD PA

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Laboratory Demographics

CLIA Number: 10D2004848

Facility Name: IVAN CASTANO MD PA

Facility Address:
4204 W 12TH AVE
HIALEAH, FL
ZIP 33012
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Facility Phone Number: 305 556-3818

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1649299652

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D2004848
LAB Type	Physician Office
Facility Name	IVAN CASTANO MD PA
Street	4204 W 12TH AVE
City	HIALEAH
State	FL
ZIP	33012
Phone	305 556-3818
CertificateType	4
CertificateEffectiveDate	3/15/2024
CertificateExpirationDate	3/14/2026
FacilityType	Waiver

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