10D0950334 CLIA NUMBER - CONCENTRA - FT LAUDERDALE - COMMERCIAL BLVD

Laboratory Demographics

CLIA Number: 10D0950334

Facility Name: CONCENTRA - FT LAUDERDALE - COMMERCIAL BLVD

Facility Address:
1007 WEST COMMERCIAL BLVD
FORT LAUDERDALE, FL
ZIP 33309
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Facility Phone Number: 954 564-2592

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1902383805

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D0950334
LAB Type	Physician Office
Facility Name	CONCENTRA - FT LAUDERDALE - COMMERCIAL BLVD
Street	1007 WEST COMMERCIAL BLVD
City	FORT LAUDERDALE
State	FL
ZIP	33309
Phone	954 564-2592
CertificateType	4
CertificateEffectiveDate	8/24/2022
CertificateExpirationDate	8/23/2024
FacilityType	Waiver

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