10D0858609 CLIA NUMBER - PCC MEDICAL HOLDINGS LLC

Laboratory Demographics

CLIA Number: 10D0858609

Facility Name: PCC MEDICAL HOLDINGS LLC

Facility Address:
220 SW 84TH AVE #106
PLANTATION, FL
ZIP 33324
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Facility Phone Number: 954 783-5151

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1215027222

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	10D0858609
LAB Type	Physician Office
Facility Name	PCC MEDICAL HOLDINGS LLC
Street	220 SW 84TH AVE #106
City	PLANTATION
State	FL
ZIP	33324
Phone	954 783-5151
CertificateType	4
CertificateEffectiveDate	1/6/2024
CertificateExpirationDate	1/5/2026
FacilityType	Waiver

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