10D2106098 CLIA NUMBER - A MED PRACTICE LLC

Laboratory Demographics

CLIA Number: 10D2106098

Facility Name: A MED PRACTICE LLC

Facility Address:
4055 NW 97TH AVENUE, SUITE 101
DORAL, FL
ZIP 33178
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Facility Phone Number: 786 801-1168

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1114387321

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	10D2106098
LAB Type	Physician Office
Facility Name	A MED PRACTICE LLC
Street	4055 NW 97TH AVENUE, SUITE 101
City	DORAL
State	FL
ZIP	33178
Phone	786 801-1168
CertificateType	4
CertificateEffectiveDate	12/10/2023
CertificateExpirationDate	12/9/2025
FacilityType	Waiver

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