Organization
CENTURION DIAGNOSTIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUBEN VALDES (PRESIDENT)
(954) 594-4091
Entity
Organization
Contact information
Practice address
1399 SHOTGUN RD, SUNRISE, FL 33326-1981
(954) 678-1262
Mailing address
1399 SHOTGUN RD, SUNRISE, FL 33326-1981
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
10D2041925
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10D2041925
CLIA ID NUMBER
FL
Enumeration date
03/06/2015
Last updated
03/06/2015
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