10D2162961 CLIA NUMBER - PHYSICIAN PRACTICES OF MSMC LLC

Laboratory Demographics

  • CLIA Code: 10D2162961
  • Facility Name: PHYSICIAN PRACTICES OF MSMC LLC
  • Facility Address: 2504 BISCAYNE BLVD
    MIAMI, FL
    ZIP 33137
  • Facility Phone: 786 598-4560
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GRACE IMSON
  • NPI Number: 1063653384
  • Taxonomy: 1744R1103X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 10D2162961
LAB Type Physician Office
Facility Name PHYSICIAN PRACTICES OF MSMC LLC
Street 2504 BISCAYNE BLVD
City MIAMI
State FL
ZIP 33137
Phone 786 598-4560
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2025
Certificate Expiration Date 3/4/2027
Facility Type Physician Office
Lab Director GRACE IMSON

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