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10D1104295 CLIA NUMBER - BRRH WOMENS CENTER

Laboratory Demographics

CLIA Number: 10D1104295

Facility Name: BRRH WOMENS CENTER

Facility Address:
690 MEADOWS ROAD ATTN TIA MUMPER
BOCA RATON, FL
ZIP 33486
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Facility Phone Number: 561 955-5000

Facility Type: Other

Certificate Type: Waiver
NPI Number: 1477709244

Taxonomy: 207RH0003X - Internal Medicine
An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered.

CLIA Record

Field Name Field Value
CLIA Number 10D1104295
LAB Type Other
Facility Name BRRH WOMENS CENTER
Street 690 MEADOWS ROAD ATTN TIA MUMPER
City BOCA RATON
State FL
ZIP 33486
Phone 561 955-5000
CertificateType 4
CertificateEffectiveDate 8/31/2023
CertificateExpirationDate 8/30/2025
FacilityType Waiver

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