10D1102326 CLIA NUMBER - BOCA RATON OBSTETRIC & GYN ASSOC

Laboratory Demographics

CLIA Number: 10D1102326

Facility Name: BOCA RATON OBSTETRIC & GYN ASSOC

Facility Address:
660 GLADES RD STE 240
BOCA RATON, FL
ZIP 33431
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Facility Phone Number: 561 368-2005

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1578048229

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1102326
LAB Type	Physician Office
Facility Name	BOCA RATON OBSTETRIC & GYN ASSOC
Street	660 GLADES RD STE 240
City	BOCA RATON
State	FL
ZIP	33431
Phone	561 368-2005
CertificateType	4
CertificateEffectiveDate	7/16/2023
CertificateExpirationDate	7/15/2025
FacilityType	Waiver

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