10D2305587 CLIA NUMBER - HOLISTIC AESTHETIC & RESEARCH CENTER

Laboratory Demographics

  • CLIA Code: 10D2305587
  • Facility Name: HOLISTIC AESTHETIC & RESEARCH CENTER
  • Facility Address: 6175 NW 153RD ST UNIT 223
    MIAMI LAKES, FL
    ZIP 33014
  • Facility Phone: 786 351-6114
  • Facility Type: Other - OUTPATIENT RESEARCH FACIL
  • Facility Type: Waiver
  • Lab Director: MARLYN MOREJON
  • NPI Number: 1619654506
  • Taxonomy: 363LA2200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2305587
LAB Type Other - OUTPATIENT RESEARCH FACIL
Facility Name HOLISTIC AESTHETIC & RESEARCH CENTER
Street 6175 NW 153RD ST UNIT 223
City MIAMI LAKES
State FL
ZIP 33014
Phone 786 351-6114
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/4/2024
Certificate Expiration Date 6/3/2026
Facility Type Other - OUTPATIENT RESEARCH FACIL
Lab Director MARLYN MOREJON

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