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10D2066957 CLIA NUMBER - SOUTH FLORIDA PREVENTIVE CARE GROUP INC

Laboratory Demographics

CLIA Number: 10D2066957

Facility Name: SOUTH FLORIDA PREVENTIVE CARE GROUP INC

Facility Address:
6750 TAFT ST
HOLLYWOOD, FL
ZIP 33024
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Facility Phone Number: 954 342-9822

Facility Type: Practitioner Other

Certificate Type: Waiver
NPI Number: 1982661294

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 10D2066957
LAB Type Practitioner Other
Facility Name SOUTH FLORIDA PREVENTIVE CARE GROUP INC
Street 6750 TAFT ST
City HOLLYWOOD
State FL
ZIP 33024
Phone 954 342-9822
CertificateType 4
CertificateEffectiveDate 10/7/2023
CertificateExpirationDate 10/6/2025
FacilityType Waiver

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