40D0909159 CLIA NUMBER - CENTRO CESKI

Laboratory Demographics

CLIA Number: 40D0909159

Facility Name: CENTRO CESKI

Facility Address:
MUNOZ RIVERA NO 404
PENUELAS, PR
ZIP 00624
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Facility Phone Number: 809 836-3288

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1194959122

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	40D0909159
LAB Type	Physician Office
Facility Name	CENTRO CESKI
Street	MUNOZ RIVERA NO 404
City	PENUELAS
State	PR
ZIP	00624
Phone	809 836-3288
CertificateType	4
CertificateEffectiveDate	11/28/2023
CertificateExpirationDate	11/27/2025
FacilityType	Waiver

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