10D1022201 CLIA NUMBER - CONVIVA MEDICAL CENTER MANAGEMENT LLC DBA CONVIVA CARE CENTER

Laboratory Demographics

  • CLIA Code: 10D1022201
  • Facility Name: CONVIVA MEDICAL CENTER MANAGEMENT LLC DBA CONVIVA CARE CENTER
  • Facility Address: 135 S POMPANO PKWY
    POMPANO BEACH, FL
    ZIP 33069
  • Facility Phone: 954 974-8901
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ABIGAIL KACZMARZEWSKI
  • NPI Number: 1659033678
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1022201
LAB Type Physician Office
Facility Name CONVIVA MEDICAL CENTER MANAGEMENT LLC DBA CONVIVA CARE CENTER
Street 135 S POMPANO PKWY
City POMPANO BEACH
State FL
ZIP 33069
Phone 954 974-8901
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/10/2024
Certificate Expiration Date 2/9/2026
Facility Type Physician Office
Lab Director ABIGAIL KACZMARZEWSKI

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This page was last updated on: 9/29/2025