10D2107839 CLIA NUMBER - MUDIT JAIN MD PA

Laboratory Demographics

  • CLIA Code: 10D2107839
  • Facility Name: MUDIT JAIN MD PA
  • Facility Address: 300 NW 70TH AVE STE 105
    PLANTATION, FL
    ZIP 33317
  • Facility Phone: 954 585-6292
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAIN MUDIT
  • NPI Number: 1356305601
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2107839
LAB Type Physician Office
Facility Name MUDIT JAIN MD PA
Street 300 NW 70TH AVE STE 105
City PLANTATION
State FL
ZIP 33317
Phone 954 585-6292
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2024
Certificate Expiration Date 1/24/2026
Facility Type Physician Office
Lab Director JAIN MUDIT

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