10D2193498 CLIA NUMBER - NOVA SOUTHEASTERN UNIV-3301 COLLEGE AVE CLIN

Laboratory Demographics

  • CLIA Code: 10D2193498
  • Facility Name: NOVA SOUTHEASTERN UNIV-3301 COLLEGE AVE CLIN
  • Facility Address: 3301 COLLEGE AVE
    DAVIE, FL
    ZIP 33314
  • Facility Phone: 954 336-3716
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAILAH ISSAC
  • NPI Number: 1881732634
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2193498
LAB Type Physician Office
Facility Name NOVA SOUTHEASTERN UNIV-3301 COLLEGE AVE CLIN
Street 3301 COLLEGE AVE
City DAVIE
State FL
ZIP 33314
Phone 954 336-3716
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2024
Certificate Expiration Date 9/21/2026
Facility Type Physician Office
Lab Director LAILAH ISSAC

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