10D2117110 CLIA NUMBER - SOUTHEAST FLA UROLOGY LLC

Laboratory Demographics

CLIA Number: 10D2117110

Facility Name: SOUTHEAST FLA UROLOGY LLC

Facility Address:
500 N HIATUS RD STE 107
PEMBROKE PINES, FL
ZIP 33026
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Facility Phone Number: 954 392-6606

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1548538598

Taxonomy: 208800000X - Urology
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

CLIA Record

Field Name	Field Value
CLIA Number	10D2117110
LAB Type	Physician Office
Facility Name	SOUTHEAST FLA UROLOGY LLC
Street	500 N HIATUS RD STE 107
City	PEMBROKE PINES
State	FL
ZIP	33026
Phone	954 392-6606
CertificateType	4
CertificateEffectiveDate	7/26/2022
CertificateExpirationDate	7/25/2024
FacilityType	Waiver

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