10D1104509 CLIA NUMBER - CAMBRIDGE MEDICAL GROUP OF WEST BOYNTON

Laboratory Demographics

CLIA Number: 10D1104509

Facility Name: CAMBRIDGE MEDICAL GROUP OF WEST BOYNTON

Facility Address:
10817 SOUTH JOG RD STE 230
BOYNTON BEACH, FL
ZIP 33437
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Facility Phone Number: 561 634-8888

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1669607636

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1104509
LAB Type	Physician Office
Facility Name	CAMBRIDGE MEDICAL GROUP OF WEST BOYNTON
Street	10817 SOUTH JOG RD STE 230
City	BOYNTON BEACH
State	FL
ZIP	33437
Phone	561 634-8888
CertificateType	4
CertificateEffectiveDate	9/3/2023
CertificateExpirationDate	9/2/2025
FacilityType	Waiver

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