10D2271703 CLIA NUMBER - CPJA CORP DBA BALTO PLASTIC SURGERY

Laboratory Demographics

  • CLIA Code: 10D2271703
  • Facility Name: CPJA CORP DBA BALTO PLASTIC SURGERY
  • Facility Address: 17900 NW 5TH STREET, STE 104
    PEMBROKE PINES, FL
    ZIP 33029
  • Facility Phone: 305 394-6064
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: PABLO A. BALTODANO
  • NPI Number: 1528806163
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 10D2271703
LAB Type Ambulatory Surgery Center
Facility Name CPJA CORP DBA BALTO PLASTIC SURGERY
Street 17900 NW 5TH STREET, STE 104
City PEMBROKE PINES
State FL
ZIP 33029
Phone 305 394-6064
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/7/2024
Certificate Expiration Date 11/6/2026
Facility Type Ambulatory Surgery Center
Lab Director PABLO A. BALTODANO

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