10D2159116 CLIA NUMBER - INNOVATIVE CLINICAL RESEARCH, INC

Laboratory Demographics

CLIA Number: 10D2159116

Facility Name: INNOVATIVE CLINICAL RESEARCH, INC

Facility Address:
14211 COMMERCE WAY
MIAMI LAKES, FL
ZIP 33016
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Facility Phone Number: 954 990-6326

Facility Type: Other - CLINICAL RESEARCH

Certificate Type: Waiver

NPI Number: 1194992826

Taxonomy: 261QS1200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2159116
LAB Type	Other - CLINICAL RESEARCH
Facility Name	INNOVATIVE CLINICAL RESEARCH, INC
Street	14211 COMMERCE WAY
City	MIAMI LAKES
State	FL
ZIP	33016
Phone	954 990-6326
CertificateType	4
CertificateEffectiveDate	12/12/2022
CertificateExpirationDate	12/11/2024
FacilityType	Waiver

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