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10D2069915 CLIA NUMBER - EVERGREEN MEDICAL CENTER PA

Laboratory Demographics

CLIA Number: 10D2069915

Facility Name: EVERGREEN MEDICAL CENTER PA

Facility Address:
400 N HIATUS RD STE 206
PEMBROKE PINES, FL
ZIP 33026
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Facility Phone Number: 954 380-8550

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1790118180

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 10D2069915
LAB Type Physician Office
Facility Name EVERGREEN MEDICAL CENTER PA
Street 400 N HIATUS RD STE 206
City PEMBROKE PINES
State FL
ZIP 33026
Phone 954 380-8550
CertificateType 4
CertificateEffectiveDate 12/5/2023
CertificateExpirationDate 12/4/2025
FacilityType Waiver

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