10D2313713 CLIA NUMBER - YGONGORANP LLC

Laboratory Demographics

  • CLIA Code: 10D2313713
  • Facility Name: YGONGORANP LLC
  • Facility Address: 540 NW 165TH STREET RD STE 310
    MIAMI, FL
    ZIP 33169
  • Facility Phone: 786 562-7479
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: YOVANY GONGORA
  • NPI Number: 1275392805
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2313713
LAB Type Physician Office
Facility Name YGONGORANP LLC
Street 540 NW 165TH STREET RD STE 310
City MIAMI
State FL
ZIP 33169
Phone 786 562-7479
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2024
Certificate Expiration Date 11/5/2026
Facility Type Physician Office
Lab Director YOVANY GONGORA

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