10D2302990 CLIA NUMBER - PRIMARY MEDICAL PHYSICIANS, LLC

Laboratory Demographics

  • CLIA Code: 10D2302990
  • Facility Name: PRIMARY MEDICAL PHYSICIANS, LLC
  • Facility Address: 6517 TAFT ST, STE 102
    HOLLYWOOD, FL
    ZIP 33024
  • Facility Phone: 954 399-9014
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ISSA MOISES
  • NPI Number: 1225622095
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 10D2302990
LAB Type Physician Office
Facility Name PRIMARY MEDICAL PHYSICIANS, LLC
Street 6517 TAFT ST, STE 102
City HOLLYWOOD
State FL
ZIP 33024
Phone 954 399-9014
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2024
Certificate Expiration Date 4/17/2026
Facility Type Physician Office
Lab Director ISSA MOISES

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This page was last updated on: 3/20/2025