10D1106542 CLIA NUMBER - FAMILY MEDICAL AND WELLNESS CENTER OF THE PALM BEACHES, LLC

Laboratory Demographics

CLIA Number: 10D1106542

Facility Name: FAMILY MEDICAL AND WELLNESS CENTER OF THE PALM BEACHES, LLC

Facility Address:
12983 SOUTHERN BLVD SUITE 102
LOXAHATCHEE, FL
ZIP 33470
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Facility Phone Number: 561 721-1953

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1942479795

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D1106542
LAB Type	Physician Office
Facility Name	FAMILY MEDICAL AND WELLNESS CENTER OF THE PALM BEACHES, LLC
Street	12983 SOUTHERN BLVD SUITE 102
City	LOXAHATCHEE
State	FL
ZIP	33470
Phone	561 721-1953
CertificateType	4
CertificateEffectiveDate	10/16/2023
CertificateExpirationDate	10/15/2025
FacilityType	Waiver

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