10D2101150 CLIA NUMBER - INDAGO RESEARCH AND HEALTH CENTER INC

Laboratory Demographics

CLIA Number: 10D2101150

Facility Name: INDAGO RESEARCH AND HEALTH CENTER INC

Facility Address:
3700 W 12 AVE STE 300
HIALEAH, FL
ZIP 33012
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Facility Phone Number: 305 825-6588

Facility Type: Other - CLINICAL TRIAL

Certificate Type: Waiver

NPI Number: 1699011122

Taxonomy: 261QR1100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2101150
LAB Type	Other - CLINICAL TRIAL
Facility Name	INDAGO RESEARCH AND HEALTH CENTER INC
Street	3700 W 12 AVE STE 300
City	HIALEAH
State	FL
ZIP	33012
Phone	305 825-6588
CertificateType	4
CertificateEffectiveDate	8/28/2023
CertificateExpirationDate	8/27/2025
FacilityType	Waiver

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