10D2209258 CLIA NUMBER - MEDWIN PA

Laboratory Demographics

  • CLIA Code: 10D2209258
  • Facility Name: MEDWIN PA
  • Facility Address: 4850 W OAKLAND PARK BLVD STE 224
    LAUDERDALE LAKES, FL
    ZIP 33313
  • Facility Phone: 786 214-2001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICAH EDWIN MD
  • NPI Number: 1275168650
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2209258
LAB Type Physician Office
Facility Name MEDWIN PA
Street 4850 W OAKLAND PARK BLVD STE 224
City LAUDERDALE LAKES
State FL
ZIP 33313
Phone 786 214-2001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/12/2025
Certificate Expiration Date 1/11/2027
Facility Type Physician Office
Lab Director MICAH EDWIN MD

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