10D2172743 CLIA NUMBER - ULTIMATE MEDICAL CENTER & SPA, LLC

Laboratory Demographics

  • CLIA Code: 10D2172743
  • Facility Name: ULTIMATE MEDICAL CENTER & SPA, LLC
  • Facility Address: 12700 SW 128TH ST STE 205
    MIAMI, FL
    ZIP 33186
  • Facility Phone: 305 278-7579
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GUILLERMO ALONSO
  • NPI Number: 1023663259
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 10D2172743
LAB Type Physician Office
Facility Name ULTIMATE MEDICAL CENTER & SPA, LLC
Street 12700 SW 128TH ST STE 205
City MIAMI
State FL
ZIP 33186
Phone 305 278-7579
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2024
Certificate Expiration Date 10/9/2026
Facility Type Physician Office
Lab Director GUILLERMO ALONSO

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