10D2077635 CLIA NUMBER - NOVA SOUTHEASTERN UNIVERSITY - INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 10D2077635
  • Facility Name: NOVA SOUTHEASTERN UNIVERSITY - INTERNAL MEDICINE
  • Facility Address: 3200 S UNIVERSITY DR STE 4128
    FORT LAUDERDALE, FL
    ZIP 33328
  • Facility Phone: 954 336-3716
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARISOL SUAREZ
  • NPI Number: 1194991059
  • Taxonomy: 103T00000X - Psychologist

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CLIA Record

Field Name Field Value
CLIA Number 10D2077635
LAB Type Physician Office
Facility Name NOVA SOUTHEASTERN UNIVERSITY - INTERNAL MEDICINE
Street 3200 S UNIVERSITY DR STE 4128
City FORT LAUDERDALE
State FL
ZIP 33328
Phone 954 336-3716
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2025
Certificate Expiration Date 4/30/2027
Facility Type Physician Office
Lab Director DR. MARISOL SUAREZ

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