10D2001662 CLIA NUMBER - PALM BEACH GENERAL SURGERY LLC

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Laboratory Demographics

CLIA Number: 10D2001662

Facility Name: PALM BEACH GENERAL SURGERY LLC

Facility Address:
12953 PALMS WEST DR STE 201
LOXAHATCHEE, FL
ZIP 33470
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Facility Phone Number: 561 795-5130

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1740630094

Taxonomy: 363L00000X - Nurse Practitioner
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

CLIA Record

Field Name	Field Value
CLIA Number	10D2001662
LAB Type	Physician Office
Facility Name	PALM BEACH GENERAL SURGERY LLC
Street	12953 PALMS WEST DR STE 201
City	LOXAHATCHEE
State	FL
ZIP	33470
Phone	561 795-5130
CertificateType	4
CertificateEffectiveDate	12/28/2023
CertificateExpirationDate	12/27/2025
FacilityType	Waiver

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