10D2161726 CLIA NUMBER - VANGUARD MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 10D2161726
  • Facility Name: VANGUARD MEDICAL GROUP
  • Facility Address: 3401 DAVIE BLVD
    FORT LAUDERDALE, FL
    ZIP 33312
  • Facility Phone: 954 870-6600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MIAN HASAN
  • NPI Number: 1912202797
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2161726
LAB Type Physician Office
Facility Name VANGUARD MEDICAL GROUP
Street 3401 DAVIE BLVD
City FORT LAUDERDALE
State FL
ZIP 33312
Phone 954 870-6600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2025
Certificate Expiration Date 2/2/2027
Facility Type Physician Office
Lab Director MIAN HASAN

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