10D2279284 CLIA NUMBER - MEMORIAL PRIMARY CARE PALM SPRINGS NORTH

Laboratory Demographics

CLIA Number: 10D2279284

Facility Name: MEMORIAL PRIMARY CARE PALM SPRINGS NORTH

Facility Address:
8649 NW 186 ST
HIALEAH, FL
ZIP 33015
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Facility Phone Number: 305 682-2666

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1144919259

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	10D2279284
LAB Type	Physician Office
Facility Name	MEMORIAL PRIMARY CARE PALM SPRINGS NORTH
Street	8649 NW 186 ST
City	HIALEAH
State	FL
ZIP	33015
Phone	305 682-2666
CertificateType	4
CertificateEffectiveDate	3/31/2023
CertificateExpirationDate	3/30/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024