10D2262079 CLIA NUMBER - ALICIA JIMENEZ APRN LLC

Laboratory Demographics

  • CLIA Code: 10D2262079
  • Facility Name: ALICIA JIMENEZ APRN LLC
  • Facility Address: 1000 W PEMBROKE RD #322
    HALLANDALE BEACH, FL
    ZIP 33009
  • Facility Phone: 954 932-0299
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALICIA JIMENEZ
  • NPI Number: 1124501804
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2262079
LAB Type Physician Office
Facility Name ALICIA JIMENEZ APRN LLC
Street 1000 W PEMBROKE RD #322
City HALLANDALE BEACH
State FL
ZIP 33009
Phone 954 932-0299
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2024
Certificate Expiration Date 6/8/2026
Facility Type Physician Office
Lab Director ALICIA JIMENEZ

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