10D2039829 CLIA NUMBER - IMAGING CENTER OF WEST PALM BEACH LLC

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Laboratory Demographics

CLIA Number: 10D2039829

Facility Name: IMAGING CENTER OF WEST PALM BEACH LLC

Facility Address:
2450 METEROCENTRE BLVD
WEST PALM BEACH, FL
ZIP 33407
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Facility Phone Number: 561 684-9020

Facility Type: Other - OP DIAGNOSTIC IMAGING CTR

Certificate Type: Waiver

NPI Number: 1578069100

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2039829
LAB Type	Other - OP DIAGNOSTIC IMAGING CTR
Facility Name	IMAGING CENTER OF WEST PALM BEACH LLC
Street	2450 METEROCENTRE BLVD
City	WEST PALM BEACH
State	FL
ZIP	33407
Phone	561 684-9020
CertificateType	4
CertificateEffectiveDate	4/18/2024
CertificateExpirationDate	4/17/2026
FacilityType	Waiver

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