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10D2225947 CLIA NUMBER - EXCELLENCE MEDICAL AND RESEARCH

Laboratory Demographics

CLIA Number: 10D2225947

Facility Name: EXCELLENCE MEDICAL AND RESEARCH

Facility Address:
111 NW 183 ST STE 206
MIAMI GARDENS, FL
ZIP 33169
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Facility Phone Number: 786 205-8666

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1700596541

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name Field Value
CLIA Number 10D2225947
LAB Type Physician Office
Facility Name EXCELLENCE MEDICAL AND RESEARCH
Street 111 NW 183 ST STE 206
City MIAMI GARDENS
State FL
ZIP 33169
Phone 786 205-8666
CertificateType 4
CertificateEffectiveDate 5/25/2023
CertificateExpirationDate 5/24/2025
FacilityType Waiver

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