10D2273364 CLIA NUMBER - ICON LABS INC

Laboratory Demographics

  • CLIA Code: 10D2273364
  • Facility Name: ICON LABS INC
  • Facility Address: 4891 NW 103RD AVE #11J
    SUNRISE, FL
    ZIP 33351
  • Facility Phone: 954 854-8971
  • Facility Type: Other - COVID WAIVED LAB
  • Facility Type: Waiver
  • Lab Director: MELVIN MARROQUIN
  • NPI Number: 1548974157
  • Taxonomy: 247ZC0005X - Pathology

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CLIA Record

Field Name Field Value
CLIA Number 10D2273364
LAB Type Other - COVID WAIVED LAB
Facility Name ICON LABS INC
Street 4891 NW 103RD AVE #11J
City SUNRISE
State FL
ZIP 33351
Phone 954 854-8971
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2024
Certificate Expiration Date 12/11/2026
Facility Type Other - COVID WAIVED LAB
Lab Director MELVIN MARROQUIN

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This page was last updated on: 6/4/2025