10D2163334 CLIA NUMBER - WAYNE N EVANCHO, DO, PA

Laboratory Demographics

  • CLIA Code: 10D2163334
  • Facility Name: WAYNE N EVANCHO, DO, PA
  • Facility Address: 1380 NE MIAMI GARDENS DR STE 285
    NORTH MIAMI BEACH, FL
    ZIP 33179
  • Facility Phone: (305) 944-8777
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TALY V. DRAI
  • NPI Number: 1619069804
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2163334
LAB Type Physician Office
Facility Name WAYNE N EVANCHO, DO, PA
Street 1380 NE MIAMI GARDENS DR STE 285
City NORTH MIAMI BEACH
State FL
ZIP 33179
Phone 3059448777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2025
Certificate Expiration Date 3/11/2027
Facility Type Physician Office
Lab Director TALY V. DRAI

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This page was last updated on: 5/18/2026