10D2197996 CLIA NUMBER - LIFETIME MEDICAL ASSOCIATES OF AVENTURA PLLC

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Laboratory Demographics

CLIA Number: 10D2197996

Facility Name: LIFETIME MEDICAL ASSOCIATES OF AVENTURA PLLC

Facility Address:
21097 NE 27TH CT STE 300
AVENTURA, FL
ZIP 33180
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Facility Phone Number: 786 480-5707

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1225050180

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D2197996
LAB Type	Physician Office
Facility Name	LIFETIME MEDICAL ASSOCIATES OF AVENTURA PLLC
Street	21097 NE 27TH CT STE 300
City	AVENTURA
State	FL
ZIP	33180
Phone	786 480-5707
CertificateType	4
CertificateEffectiveDate	10/29/2022
CertificateExpirationDate	10/28/2024
FacilityType	Waiver

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