10D0932954 CLIA NUMBER - ANN STORCK CENTER INC

Laboratory Demographics

CLIA Code: 10D0932954
Facility Name: ANN STORCK CENTER INC
Facility Address: 1790 SW 43RD WAY
FORT LAUDERDALE, FL
ZIP 33317
Facility Phone: 954 584-8000
Facility Type: Intermediate Care Facility for Mentally Retarded
Facility Type: Waiver
Lab Director: HERNANDO CHONG MD
NPI Number: 1730229212
Taxonomy: 320900000X - Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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CLIA Record

Field Name	Field Value
CLIA Number	10D0932954
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	ANN STORCK CENTER INC
Street	1790 SW 43RD WAY
City	FORT LAUDERDALE
State	FL
ZIP	33317
Phone	954 584-8000
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	9/3/2025
Certificate Expiration Date	9/2/2027
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	HERNANDO CHONG MD

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This page was last updated on: 9/29/2025