10D2014771 CLIA NUMBER - WALNUT CREEK MEDICAL CENTER

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Laboratory Demographics

CLIA Number: 10D2014771

Facility Name: WALNUT CREEK MEDICAL CENTER

Facility Address:
1779 N UNIVERSITY DR STE 101
PEMBROKE PINES, FL
ZIP 33024
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Facility Phone Number: 954 964-6281

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1508041898

Taxonomy: 207RG0100X - Internal Medicine
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

CLIA Record

Field Name	Field Value
CLIA Number	10D2014771
LAB Type	Physician Office
Facility Name	WALNUT CREEK MEDICAL CENTER
Street	1779 N UNIVERSITY DR STE 101
City	PEMBROKE PINES
State	FL
ZIP	33024
Phone	954 964-6281
CertificateType	4
CertificateEffectiveDate	10/15/2022
CertificateExpirationDate	10/14/2024
FacilityType	Waiver

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