10D0714591 CLIA NUMBER - BRUCE WISHNOV DO PA

Laboratory Demographics

CLIA Number: 10D0714591

Facility Name: BRUCE WISHNOV DO PA

Facility Address:
22065 STATE ROAD 7
BOCA RATON, FL
ZIP 33428
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Facility Phone Number: 561 488-4847

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1134296395

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D0714591
LAB Type	Physician Office
Facility Name	BRUCE WISHNOV DO PA
Street	22065 STATE ROAD 7
City	BOCA RATON
State	FL
ZIP	33428
Phone	561 488-4847
CertificateType	4
CertificateEffectiveDate	7/19/2023
CertificateExpirationDate	7/18/2025
FacilityType	Waiver

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