10D2052812 CLIA NUMBER - JOSE JUAN DIAZ DO PA DBA INTEGRATIVE SPINE AND SPORTS LLC

Laboratory Demographics

  • CLIA Code: 10D2052812
  • Facility Name: JOSE JUAN DIAZ DO PA DBA INTEGRATIVE SPINE AND SPORTS LLC
  • Facility Address: 3308 NE 34TH ST
    FORT LAUDERDALE, FL
    ZIP 33308
  • Facility Phone: 954 564-3200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSE J. DIAZ
  • NPI Number: 1447595533
  • Taxonomy: 208100000X - Physical Medicine & Rehabilitation

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CLIA Record

Field Name Field Value
CLIA Number 10D2052812
LAB Type Physician Office
Facility Name JOSE JUAN DIAZ DO PA DBA INTEGRATIVE SPINE AND SPORTS LLC
Street 3308 NE 34TH ST
City FORT LAUDERDALE
State FL
ZIP 33308
Phone 954 564-3200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/18/2025
Certificate Expiration Date 1/17/2027
Facility Type Physician Office
Lab Director JOSE J. DIAZ

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