10D2252603 CLIA NUMBER - LA CAPITAL MEDICAL CENTER DBA LA FAMILIA MEDICAL GROUP

Laboratory Demographics

CLIA Number: 10D2252603

Facility Name: LA CAPITAL MEDICAL CENTER DBA LA FAMILIA MEDICAL GROUP

Facility Address:
1550 W 84 ST #31
HIALEAH, FL
ZIP 33014
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Facility Phone Number: 305 901-1191

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1356932586

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	10D2252603
LAB Type	Community Clinic
Facility Name	LA CAPITAL MEDICAL CENTER DBA LA FAMILIA MEDICAL GROUP
Street	1550 W 84 ST #31
City	HIALEAH
State	FL
ZIP	33014
Phone	305 901-1191
CertificateType	4
CertificateEffectiveDate	2/14/2024
CertificateExpirationDate	2/13/2026
FacilityType	Waiver

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