10D2247206 CLIA NUMBER - EXCELLENCE HEALTHCARE, CORP

Laboratory Demographics

CLIA Number: 10D2247206

Facility Name: EXCELLENCE HEALTHCARE, CORP

Facility Address:
16283 SW 88TH ST
MIAMI, FL
ZIP 33196
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Facility Phone Number: 786 597-0331

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1013684992

Taxonomy: 363LP0808X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	10D2247206
LAB Type	Physician Office
Facility Name	EXCELLENCE HEALTHCARE, CORP
Street	16283 SW 88TH ST
City	MIAMI
State	FL
ZIP	33196
Phone	786 597-0331
CertificateType	4
CertificateEffectiveDate	1/5/2024
CertificateExpirationDate	1/4/2026
FacilityType	Waiver

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