10D2041122 CLIA NUMBER - CALZADA PRIMARY CARE PA

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Laboratory Demographics

CLIA Number: 10D2041122

Facility Name: CALZADA PRIMARY CARE PA

Facility Address:
2301 N UNIVERISTY DR STE 108
PEMBROKE PINES, FL
ZIP 33024
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Facility Phone Number: 954 987-4900

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1225301013

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2041122
LAB Type	Physician Office
Facility Name	CALZADA PRIMARY CARE PA
Street	2301 N UNIVERISTY DR STE 108
City	PEMBROKE PINES
State	FL
ZIP	33024
Phone	954 987-4900
CertificateType	4
CertificateEffectiveDate	5/17/2022
CertificateExpirationDate	5/16/2024
FacilityType	Waiver

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