10D0942408 CLIA NUMBER - WOODHOUSE

Laboratory Demographics

CLIA Number: 10D0942408

Facility Name: WOODHOUSE

Facility Address:
1001 NE 3 AVENUE
POMPANO BEACH, FL
ZIP 33060
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Facility Phone Number: 954 786-0344

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1922131796

Taxonomy: 320600000X - Residential Treatment Facility, Intellectual and/or Developmental Disabilities
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.

CLIA Record

Field Name	Field Value
CLIA Number	10D0942408
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	WOODHOUSE
Street	1001 NE 3 AVENUE
City	POMPANO BEACH
State	FL
ZIP	33060
Phone	954 786-0344
CertificateType	4
CertificateEffectiveDate	12/16/2022
CertificateExpirationDate	12/15/2024
FacilityType	Waiver

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