10D2215382 CLIA NUMBER - PRESTIGE PHYSICIANS LLC

Laboratory Demographics

  • CLIA Code: 10D2215382
  • Facility Name: PRESTIGE PHYSICIANS LLC
  • Facility Address: 1200 E BROWARD BLVD
    FORT LAUDERDALE, FL
    ZIP 33301
  • Facility Phone: 954 771-0611
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIRA B. FENTON
  • NPI Number: 1699217281
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2215382
LAB Type Physician Office
Facility Name PRESTIGE PHYSICIANS LLC
Street 1200 E BROWARD BLVD
City FORT LAUDERDALE
State FL
ZIP 33301
Phone 954 771-0611
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2025
Certificate Expiration Date 3/2/2027
Facility Type Physician Office
Lab Director KIRA B. FENTON

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