10D2165635 CLIA NUMBER - INTEGRUM MEDICAL GROUP, LLC DBA INTEGRUM MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 10D2165635
  • Facility Name: INTEGRUM MEDICAL GROUP, LLC DBA INTEGRUM MEDICAL GROUP
  • Facility Address: 8756 SW 72ND STREET
    MIAMI, FL
    ZIP 33173
  • Facility Phone: 786 798-7004
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RITA M. CARRALERO
  • NPI Number: 1770053761
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2165635
LAB Type Physician Office
Facility Name INTEGRUM MEDICAL GROUP, LLC DBA INTEGRUM MEDICAL GROUP
Street 8756 SW 72ND STREET
City MIAMI
State FL
ZIP 33173
Phone 786 798-7004
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/2/2023
Certificate Expiration Date 5/1/2025
Facility Type Physician Office
Lab Director RITA M. CARRALERO

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This page was last updated on: 3/20/2025