10D2273970 CLIA NUMBER - CONVIVA MEDICAL CENTER MANAGEMENT DBA CONVIVA SENIOR PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 10D2273970
  • Facility Name: CONVIVA MEDICAL CENTER MANAGEMENT DBA CONVIVA SENIOR PRIMARY CARE
  • Facility Address: 1190 NW 95 ST - STE 406
    MIAMI, FL
    ZIP 33150
  • Facility Phone: 305 836-6221
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SENDY JEAN-LOUIS
  • NPI Number: 1639483449
  • Taxonomy: 207P00000X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2273970
LAB Type Physician Office
Facility Name CONVIVA MEDICAL CENTER MANAGEMENT DBA CONVIVA SENIOR PRIMARY CARE
Street 1190 NW 95 ST - STE 406
City MIAMI
State FL
ZIP 33150
Phone 305 836-6221
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Physician Office
Lab Director SENDY JEAN-LOUIS

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