10D2171845 CLIA NUMBER - INDEPENDENT MEDICAL GROUP, LLC

Laboratory Demographics

CLIA Number: 10D2171845

Facility Name: INDEPENDENT MEDICAL GROUP, LLC

Facility Address:
3800 INVERRARY BLVD STE 109
FORT LAUDERDALE, FL
ZIP 33319
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Facility Phone Number: 786 523-2562

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1689327074

Taxonomy: 207RI0200X - Internal Medicine
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.

CLIA Record

Field Name	Field Value
CLIA Number	10D2171845
LAB Type	Physician Office
Facility Name	INDEPENDENT MEDICAL GROUP, LLC
Street	3800 INVERRARY BLVD STE 109
City	FORT LAUDERDALE
State	FL
ZIP	33319
Phone	786 523-2562
CertificateType	4
CertificateEffectiveDate	9/10/2023
CertificateExpirationDate	9/9/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024