10D2077643 CLIA NUMBER - NOVA SOUTHEASTERN UNIVERSITY - EMPLOYEE HEALTH & WELLNESS

Laboratory Demographics

  • CLIA Code: 10D2077643
  • Facility Name: NOVA SOUTHEASTERN UNIVERSITY - EMPLOYEE HEALTH & WELLNESS
  • Facility Address: 3200 S UNIVERSITY DR STE 4372 ZIFF BLDG 3RD FLOOR
    FORT LAUDERDALE, FL
    ZIP 33328
  • Facility Phone: 954 336-3716
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: GINA FOSTER-MOUMOUTJIS
  • NPI Number: 1366790552
  • Taxonomy: 103K00000X - Behavior Analyst

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CLIA Record

Field Name Field Value
CLIA Number 10D2077643
LAB Type Physician Office
Facility Name NOVA SOUTHEASTERN UNIVERSITY - EMPLOYEE HEALTH & WELLNESS
Street 3200 S UNIVERSITY DR STE 4372 ZIFF BLDG 3RD FLOOR
City FORT LAUDERDALE
State FL
ZIP 33328
Phone 954 336-3716
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 5/13/2024
Certificate Expiration Date 5/12/2026
Facility Type Physician Office
Lab Director GINA FOSTER-MOUMOUTJIS

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This page was last updated on: 6/4/2025