10D0715689 CLIA NUMBER - JM FAMILY AUTOMOTIVE LLC

Laboratory Demographics

CLIA Number: 10D0715689

Facility Name: JM FAMILY AUTOMOTIVE LLC

Facility Address:
111 JIM MORAN BLVD
DEERFIELD BEACH, FL
ZIP 33442
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Facility Phone Number: 954 429-2418

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1053701565

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0715689
LAB Type	Physician Office
Facility Name	JM FAMILY AUTOMOTIVE LLC
Street	111 JIM MORAN BLVD
City	DEERFIELD BEACH
State	FL
ZIP	33442
Phone	954 429-2418
CertificateType	4
CertificateEffectiveDate	6/20/2022
CertificateExpirationDate	6/19/2024
FacilityType	Waiver

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