10D2061684 CLIA NUMBER - LISA E MARK MD LLC

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Laboratory Demographics

CLIA Number: 10D2061684

Facility Name: LISA E MARK MD LLC

Facility Address:
9917 PINES BLVD
PEMBROKE PINES, FL
ZIP 33024
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Facility Phone Number: (954) 330-8604

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1750688800

Taxonomy: 207VG0400X - Obstetrics & Gynecology
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	10D2061684
LAB Type	PHYSICIAN OFFICE
Facility Name	LISA E MARK MD LLC
Street	9917 PINES BLVD
City	PEMBROKE PINES
State	FL
ZIP	33024
Phone	(954) 330-8604

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This page was last updated on: 5/11/2023