10D2054251 CLIA NUMBER - LEE A GIBSTEIN MD

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Laboratory Demographics

CLIA Number: 10D2054251

Facility Name: LEE A GIBSTEIN MD

Facility Address:
1166 KANE CONCOURSE 3RD FL
BAY HARBOR ISLANDS, FL
ZIP 33154
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Facility Phone Number: 305 865-2802

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1851489066

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	10D2054251
LAB Type	Physician Office
Facility Name	LEE A GIBSTEIN MD
Street	1166 KANE CONCOURSE 3RD FL
City	BAY HARBOR ISLANDS
State	FL
ZIP	33154
Phone	305 865-2802
CertificateType	4
CertificateEffectiveDate	9/18/2023
CertificateExpirationDate	9/17/2025
FacilityType	Waiver

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