10D2023341 CLIA NUMBER - CONSTELLATION MEDICAL GROUP LLC

Laboratory Demographics

  • CLIA Code: 10D2023341
  • Facility Name: CONSTELLATION MEDICAL GROUP LLC
  • Facility Address: 15600 NW 67 AVENUE STE 105
    MIAMI LAKES, FL
    ZIP 33014
  • Facility Phone: 305 760-2525
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELDA REGALADO
  • NPI Number: 1225794852
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 10D2023341
LAB Type Physician Office
Facility Name CONSTELLATION MEDICAL GROUP LLC
Street 15600 NW 67 AVENUE STE 105
City MIAMI LAKES
State FL
ZIP 33014
Phone 305 760-2525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Physician Office
Lab Director ELDA REGALADO

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