10D2061484 CLIA NUMBER - PLANTATION HOME TRAINING

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Laboratory Demographics

CLIA Number: 10D2061484

Facility Name: PLANTATION HOME TRAINING

Facility Address:
8144 W BROWARD BLVD
PLANTATION, FL
ZIP 33324
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Facility Phone Number: 954 473-9138

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1316280068

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2061484
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	PLANTATION HOME TRAINING
Street	8144 W BROWARD BLVD
City	PLANTATION
State	FL
ZIP	33324
Phone	954 473-9138
CertificateType	4
CertificateEffectiveDate	6/28/2023
CertificateExpirationDate	6/27/2025
FacilityType	Waiver

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