10D2119030 CLIA NUMBER - TREASURE COAST COMMUNITY HEALTH INC

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Laboratory Demographics

CLIA Number: 10D2119030

Facility Name: TREASURE COAST COMMUNITY HEALTH INC

Facility Address:
13505 US HWY 1
SEBASTIAN, FL
ZIP 32958
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Facility Phone Number: 772 571-1986

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1093266793

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2119030
LAB Type	Federally Qualified Health Center
Facility Name	TREASURE COAST COMMUNITY HEALTH INC
Street	13505 US HWY 1
City	SEBASTIAN
State	FL
ZIP	32958
Phone	772 571-1986
CertificateType	4
CertificateEffectiveDate	9/19/2022
CertificateExpirationDate	9/18/2024
FacilityType	Waiver

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