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10D0285802 CLIA NUMBER - PLANTATION MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 10D0285802

Facility Name: PLANTATION MEDICAL CLINIC

Facility Address:
100 NW 82ND AVENUE #206
PLANTATION, FL
ZIP 33324
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Facility Phone Number: 954 424-7504

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1457500720

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 10D0285802
LAB Type Physician Office
Facility Name PLANTATION MEDICAL CLINIC
Street 100 NW 82ND AVENUE #206
City PLANTATION
State FL
ZIP 33324
Phone 954 424-7504
CertificateType 4
CertificateEffectiveDate 9/1/2022
CertificateExpirationDate 8/31/2024
FacilityType Waiver

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