Provider Demographics
NPI:1114813797
Name:FLORIDA CLINICAL DX INC
Entity type:Organization
Organization Name:FLORIDA CLINICAL DX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NASIR
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-253-4001
Mailing Address - Street 1:10001 W OAKLAND PARK BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351-6925
Mailing Address - Country:US
Mailing Address - Phone:863-237-4693
Mailing Address - Fax:
Practice Address - Street 1:10001 W OAKLAND PARK BLVD STE 301
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6925
Practice Address - Country:US
Practice Address - Phone:863-237-4693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-17
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory