10D2176749 CLIA NUMBER - ULTRA MEDICAL LLC

Laboratory Demographics

  • CLIA Code: 10D2176749
  • Facility Name: ULTRA MEDICAL LLC
  • Facility Address: 10350 PINES BLVD #D102
    PEMBROKE PINES, FL
    ZIP 33026
  • Facility Phone: 786 286-1864
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALFREDO E. INFANTE
  • NPI Number: 1972133163
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2176749
LAB Type Physician Office
Facility Name ULTRA MEDICAL LLC
Street 10350 PINES BLVD #D102
City PEMBROKE PINES
State FL
ZIP 33026
Phone 786 286-1864
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Physician Office
Lab Director ALFREDO E. INFANTE

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