10D2137411 CLIA NUMBER - RENAISSANCE RESEARCH AND MEDICAL GROUP

Laboratory Demographics

CLIA Number: 10D2137411

Facility Name: RENAISSANCE RESEARCH AND MEDICAL GROUP

Facility Address:
629 SW 4 STREET UNIT 2
CAPE CORAL, FL
ZIP 33991
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Facility Phone Number: (786) 261-9820

Facility Type: PHYSICIAN OFFICE

Certificate Type: Waiver

NPI Number: 1528543725

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2137411
LAB Type	PHYSICIAN OFFICE
Facility Name	RENAISSANCE RESEARCH AND MEDICAL GROUP
Street	629 SW 4 STREET UNIT 2
City	CAPE CORAL
State	FL
ZIP	33991
Phone	(786) 261-9820

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This page was last updated on: 5/11/2023