10D1097078 CLIA NUMBER - FOUNDCARE

Laboratory Demographics

CLIA Number: 10D1097078

Facility Name: FOUNDCARE

Facility Address:
2330 S CONGRESS AVE AVE
WEST PALM BEACH, FL
ZIP 33406
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Facility Phone Number: 561 432-5849

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1659871689

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1097078
LAB Type	Federally Qualified Health Center
Facility Name	FOUNDCARE
Street	2330 S CONGRESS AVE AVE
City	WEST PALM BEACH
State	FL
ZIP	33406
Phone	561 432-5849
CertificateType	4
CertificateEffectiveDate	3/18/2023
CertificateExpirationDate	3/17/2025
FacilityType	Waiver

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