10D0968526 CLIA NUMBER - CRESTHAVEN

Laboratory Demographics

CLIA Number: 10D0968526

Facility Name: CRESTHAVEN

Facility Address:
5100 CRESTHAVEN BLVD
WEST PALM BEACH, FL
ZIP 33415
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Facility Phone Number: 561 964-2828

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1154556157

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	10D0968526
LAB Type	Assisted Living Facility
Facility Name	CRESTHAVEN
Street	5100 CRESTHAVEN BLVD
City	WEST PALM BEACH
State	FL
ZIP	33415
Phone	561 964-2828
CertificateType	4
CertificateEffectiveDate	12/14/2023
CertificateExpirationDate	12/13/2025
FacilityType	Waiver

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