10D2171845 CLIA NUMBER - INDEPENDENT MEDICAL GROUP, LLC

Laboratory Demographics

  • CLIA Code: 10D2171845
  • Facility Name: INDEPENDENT MEDICAL GROUP, LLC
  • Facility Address: 3800 INVERRARY BLVD STE 109
    FORT LAUDERDALE, FL
    ZIP 33319
  • Facility Phone: 786 523-2562
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FRANTZY BERNARD
  • NPI Number: 1689327074
  • Taxonomy: 207RI0200X - Internal Medicine

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2023
Certificate Expiration Date 9/9/2025
Facility Type Physician Office
Lab Director FRANTZY BERNARD

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