10D2060573 CLIA NUMBER - COLUMBIA MEDICAL GROUP LLC

Laboratory Demographics

  • CLIA Code: 10D2060573
  • Facility Name: COLUMBIA MEDICAL GROUP LLC
  • Facility Address: 3907 JOG RD
    GREENACRES, FL
    ZIP 33467
  • Facility Phone: 561 432-3455
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MITCHELL A. PERELMAN
  • NPI Number: 1306255237
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2060573
LAB Type Physician Office
Facility Name COLUMBIA MEDICAL GROUP LLC
Street 3907 JOG RD
City GREENACRES
State FL
ZIP 33467
Phone 561 432-3455
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/13/2025
Certificate Expiration Date 6/12/2027
Facility Type Physician Office
Lab Director MITCHELL A. PERELMAN

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