10D1104526 CLIA NUMBER - INNOVATIVE HEALTHCARE FOR WOMEN LLC

Laboratory Demographics

CLIA Number: 10D1104526

Facility Name: INNOVATIVE HEALTHCARE FOR WOMEN LLC

Facility Address:
660 GLADES RD STE 340
BOCA RATON, FL
ZIP 33431
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Facility Phone Number: 561 620-2639

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1316069719

Taxonomy: 171W00000X - Contractor
A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering).

CLIA Record

Field Name	Field Value
CLIA Number	10D1104526
LAB Type	Physician Office
Facility Name	INNOVATIVE HEALTHCARE FOR WOMEN LLC
Street	660 GLADES RD STE 340
City	BOCA RATON
State	FL
ZIP	33431
Phone	561 620-2639
CertificateType	4
CertificateEffectiveDate	9/4/2023
CertificateExpirationDate	9/3/2025
FacilityType	Waiver

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