10D2121346 CLIA NUMBER - SHENANDOAH MEDICAL CARE CENTER LLC

Laboratory Demographics

CLIA Number: 10D2121346

Facility Name: SHENANDOAH MEDICAL CARE CENTER LLC

Facility Address:
6234 S CONGRESS AVE STE F1
LANTANA, FL
ZIP 33462
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Facility Phone Number: (561) 853-7233

Facility Type: OTHER PRACTITIONER

Certificate Type: Waiver

NPI Number: 1740608801

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2121346
LAB Type	OTHER PRACTITIONER
Facility Name	SHENANDOAH MEDICAL CARE CENTER LLC
Street	6234 S CONGRESS AVE STE F1
City	LANTANA
State	FL
ZIP	33462
Phone	(561) 853-7233

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This page was last updated on: 5/11/2023