10D2156316 CLIA NUMBER - PROHEALTH MEDICAL DORAL

Laboratory Demographics

CLIA Number: 10D2156316

Facility Name: PROHEALTH MEDICAL DORAL

Facility Address:
8247 NW 36 ST
DORAL, FL
ZIP 33166
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Facility Phone Number: 786 333-2954

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1023568318

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D2156316
LAB Type	Physician Office
Facility Name	PROHEALTH MEDICAL DORAL
Street	8247 NW 36 ST
City	DORAL
State	FL
ZIP	33166
Phone	786 333-2954
CertificateType	4
CertificateEffectiveDate	10/16/2022
CertificateExpirationDate	10/15/2024
FacilityType	Waiver

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