10D2276815 CLIA NUMBER - PROACTIVE CLINICAL RESEARCH LLC

Laboratory Demographics

  • CLIA Code: 10D2276815
  • Facility Name: PROACTIVE CLINICAL RESEARCH LLC
  • Facility Address: 5353 N FEDERAL HWY - STE 406
    FORT LAUDERDALE, FL
    ZIP 33308
  • Facility Phone: 954 938-2843
  • Facility Type: Other - RESEARCH FACILITY
  • Facility Type: Waiver
  • Lab Director: JOSE CEVALLOS
  • NPI Number: 1225765241
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2276815
LAB Type Other - RESEARCH FACILITY
Facility Name PROACTIVE CLINICAL RESEARCH LLC
Street 5353 N FEDERAL HWY - STE 406
City FORT LAUDERDALE
State FL
ZIP 33308
Phone 954 938-2843
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/15/2025
Certificate Expiration Date 2/14/2027
Facility Type Other - RESEARCH FACILITY
Lab Director JOSE CEVALLOS

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