10D2310859 CLIA NUMBER - AZZAM MUFTAH MD PA

Laboratory Demographics

  • CLIA Code: 10D2310859
  • Facility Name: AZZAM MUFTAH MD PA
  • Facility Address: 15205 CORTEZ BLVD
    BROOKSVILLE, FL
    ZIP 34613
  • Facility Phone: 352 597-7744
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: AZZAM MUFTAH
  • NPI Number: 1417918988
  • Taxonomy: 207RG0100X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2310859
LAB Type Physician Office
Facility Name AZZAM MUFTAH MD PA
Street 15205 CORTEZ BLVD
City BROOKSVILLE
State FL
ZIP 34613
Phone 352 597-7744
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 9/11/2024
Certificate Expiration Date 9/10/2026
Facility Type Physician Office
Lab Director AZZAM MUFTAH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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