10D2232352 CLIA NUMBER - FUENTES MEDICAL CENTER INC

Laboratory Demographics

CLIA Number: 10D2232352

Facility Name: FUENTES MEDICAL CENTER INC

Facility Address:
18400 NW 75 PLACE SUITE 116
HIALEAH, FL
ZIP 33015
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Facility Phone Number: 786 584-8531

Facility Type: Other - MEDICAL CENTER

Certificate Type: Waiver

NPI Number: 1780260224

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	10D2232352
LAB Type	Other - MEDICAL CENTER
Facility Name	FUENTES MEDICAL CENTER INC
Street	18400 NW 75 PLACE SUITE 116
City	HIALEAH
State	FL
ZIP	33015
Phone	786 584-8531
CertificateType	4
CertificateEffectiveDate	8/12/2023
CertificateExpirationDate	8/11/2025
FacilityType	Waiver

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