10D2202672 CLIA NUMBER - INTEGRATED COMPREHENSIVE URGENT CARE LLC

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Laboratory Demographics

CLIA Number: 10D2202672

Facility Name: INTEGRATED COMPREHENSIVE URGENT CARE LLC

Facility Address:
3595 WEST 20TH AVENUE SUITE 130
HIALEAH, FL
ZIP 33012
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Facility Phone Number: 305 883-8488

Facility Type: Other - URGENT CARE MEDICAL OFC

Certificate Type: Waiver

NPI Number: 1568069441

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	10D2202672
LAB Type	Other - URGENT CARE MEDICAL OFC
Facility Name	INTEGRATED COMPREHENSIVE URGENT CARE LLC
Street	3595 WEST 20TH AVENUE SUITE 130
City	HIALEAH
State	FL
ZIP	33012
Phone	305 883-8488
CertificateType	4
CertificateEffectiveDate	11/30/2022
CertificateExpirationDate	11/29/2024
FacilityType	Waiver

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