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10D1007999 CLIA NUMBER - PET IMAGING INSTITUTE OF SOUTH FLORIDA

Laboratory Demographics

CLIA Number: 10D1007999

Facility Name: PET IMAGING INSTITUTE OF SOUTH FLORIDA

Facility Address:
1150 NORTH 35TH AVE STE 665
HOLLYWOOD, FL
ZIP 33021
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Facility Phone Number: 954 981-6668

Facility Type: Other

Certificate Type: Waiver
NPI Number: 1124020656

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name Field Value
CLIA Number 10D1007999
LAB Type Other
Facility Name PET IMAGING INSTITUTE OF SOUTH FLORIDA
Street 1150 NORTH 35TH AVE STE 665
City HOLLYWOOD
State FL
ZIP 33021
Phone 954 981-6668
CertificateType 4
CertificateEffectiveDate 1/7/2023
CertificateExpirationDate 1/6/2025
FacilityType Waiver

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