10D2141813 CLIA NUMBER - VIDA MEDICAL GROUP PA

Laboratory Demographics

  • CLIA Code: 10D2141813
  • Facility Name: VIDA MEDICAL GROUP PA
  • Facility Address: 26847 SOUTH DIXIE HWY
    HOMESTEAD, FL
    ZIP 33032
  • Facility Phone: 305 258-9352
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAGABERTO MARQUEZ
  • NPI Number: 1245743889
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2141813
LAB Type Physician Office
Facility Name VIDA MEDICAL GROUP PA
Street 26847 SOUTH DIXIE HWY
City HOMESTEAD
State FL
ZIP 33032
Phone 305 258-9352
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2023
Certificate Expiration Date 12/20/2025
Facility Type Physician Office
Lab Director DAGABERTO MARQUEZ

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