10D2009187 CLIA NUMBER - EXCELLENT WOMAN CARE LLC

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Laboratory Demographics

CLIA Number: 10D2009187

Facility Name: EXCELLENT WOMAN CARE LLC

Facility Address:
2226 SE 2ND ST
BOYNTON BEACH, FL
ZIP 33435
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Facility Phone Number: 561 476-0900

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1780259242

Taxonomy: 207VX0000X - Obstetrics & Gynecology
A physician who specializes in diagnosis, treatment, and management of patients with obstetric conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	10D2009187
LAB Type	Physician Office
Facility Name	EXCELLENT WOMAN CARE LLC
Street	2226 SE 2ND ST
City	BOYNTON BEACH
State	FL
ZIP	33435
Phone	561 476-0900
CertificateType	4
CertificateEffectiveDate	6/28/2022
CertificateExpirationDate	6/27/2024
FacilityType	Waiver

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