10D0964619 CLIA NUMBER - SOUTHEAST PERINATAL ASSOCIATES, INC

Laboratory Demographics

CLIA Number: 10D0964619

Facility Name: SOUTHEAST PERINATAL ASSOCIATES, INC

Facility Address:
220 SW 84 AVE SUITE 104
PLANTATION, FL
ZIP 33324
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Facility Phone Number: 954 585-2229

Facility Type: Independent

Certificate Type: Waiver

NPI Number: 1477535508

Taxonomy: 207VM0101X - Obstetrics & Gynecology
An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies.

CLIA Record

Field Name	Field Value
CLIA Number	10D0964619
LAB Type	Independent
Facility Name	SOUTHEAST PERINATAL ASSOCIATES, INC
Street	220 SW 84 AVE SUITE 104
City	PLANTATION
State	FL
ZIP	33324
Phone	954 585-2229
CertificateType	4
CertificateEffectiveDate	8/30/2023
CertificateExpirationDate	8/29/2025
FacilityType	Waiver

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