10D2185358 CLIA NUMBER - ISLAND MD LLC

Laboratory Demographics

CLIA Number: 10D2185358

Facility Name: ISLAND MD LLC

Facility Address:
90130 OLD HWY STE 1
TAVERNIER, FL
ZIP 33070
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Facility Phone Number: 305 852-9300

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1619508793

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D2185358
LAB Type	Physician Office
Facility Name	ISLAND MD LLC
Street	90130 OLD HWY STE 1
City	TAVERNIER
State	FL
ZIP	33070
Phone	305 852-9300
CertificateType	4
CertificateEffectiveDate	6/2/2022
CertificateExpirationDate	6/1/2024
FacilityType	Waiver

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