10D1105232 CLIA NUMBER - TOTAL MD

Laboratory Demographics

CLIA Number: 10D1105232

Facility Name: TOTAL MD

Facility Address:
8200 OKEECHOBEE BLVD
WEST PALM BEACH, FL
ZIP 33411
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Facility Phone Number: 561 964-1111

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1942696190

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D1105232
LAB Type	Physician Office
Facility Name	TOTAL MD
Street	8200 OKEECHOBEE BLVD
City	WEST PALM BEACH
State	FL
ZIP	33411
Phone	561 964-1111
CertificateType	4
CertificateEffectiveDate	9/21/2023
CertificateExpirationDate	9/20/2025
FacilityType	Waiver

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