10D0285849 CLIA NUMBER - PEDIATRIC ASSOCIATES - WESTON

Laboratory Demographics

CLIA Number: 10D0285849

Facility Name: PEDIATRIC ASSOCIATES - WESTON

Facility Address:
1695 N PARK DR #101
WESTON, FL
ZIP 33326
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Facility Phone Number: 954 965-7754

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1295891091

Taxonomy: 2251N0400X - Physical Therapist
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Neurologic Physical Therapy, who has demonstrated specialized knowledge and skill in neuroanatomy and neurophysiology, including knowledge of central, peripheral, and autonomic nervous systems in populations with and without neurologic conditions; motor control and movement sciences in populations with and without neurologic conditions; behavioral sciences, including psychology and neuropsychology, and psychiatry; and medical management and pharmacology.

CLIA Record

Field Name	Field Value
CLIA Number	10D0285849
LAB Type	Physician Office
Facility Name	PEDIATRIC ASSOCIATES - WESTON
Street	1695 N PARK DR #101
City	WESTON
State	FL
ZIP	33326
Phone	954 965-7754
CertificateType	2
CertificateEffectiveDate	11/5/2022
CertificateExpirationDate	11/4/2024
FacilityType	Compliance

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