10D2163252 CLIA NUMBER - D DE LA VEGA MD PA

Laboratory Demographics

  • CLIA Code: 10D2163252
  • Facility Name: D DE LA VEGA MD PA
  • Facility Address: 11093 NW 138 ST STE 112
    HIALEAH GARDENS, FL
    ZIP 33018
  • Facility Phone: 305 552-0303
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAGOBERTO DE LA VEGA
  • NPI Number: 1063464527
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2163252
LAB Type Physician Office
Facility Name D DE LA VEGA MD PA
Street 11093 NW 138 ST STE 112
City HIALEAH GARDENS
State FL
ZIP 33018
Phone 305 552-0303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2025
Certificate Expiration Date 3/10/2027
Facility Type Physician Office
Lab Director DAGOBERTO DE LA VEGA

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