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10D1029202 CLIA NUMBER - CONVIVA MEDICAL CENTER MANAGEMENT LLC DBA CONVIVA CARE CENTER

Laboratory Demographics

CLIA Number: 10D1029202

Facility Name: CONVIVA MEDICAL CENTER MANAGEMENT LLC DBA CONVIVA CARE CENTER

Facility Address:
7593 BOYNTON BEACH BLVD STE 140
BOYNTON BEACH, FL
ZIP 33437
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Facility Phone Number: 561 364-4840

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1770156010

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name Field Value
CLIA Number 10D1029202
LAB Type Physician Office
Facility Name CONVIVA MEDICAL CENTER MANAGEMENT LLC DBA CONVIVA CARE CENTER
Street 7593 BOYNTON BEACH BLVD STE 140
City BOYNTON BEACH
State FL
ZIP 33437
Phone 561 364-4840
CertificateType 4
CertificateEffectiveDate 8/12/2022
CertificateExpirationDate 8/11/2024
FacilityType Waiver

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