10D2124110 CLIA NUMBER - BETHESDA HEALTH PHYSICIAN GROUP, INC DBA BAPTIST HEALTH MATERNAL-FETAL MEDICINE BOYNTON BEACH

Laboratory Demographics

CLIA Number: 10D2124110

Facility Name: BETHESDA HEALTH PHYSICIAN GROUP, INC DBA BAPTIST HEALTH MATERNAL-FETAL MEDICINE BOYNTON BEACH

Facility Address:
1325 S CONGRESS AVE SUITE 103
BOYNTON BEACH, FL
ZIP 33426
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Facility Phone Number: 561 364-0200

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1730329038

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2124110
LAB Type	Physician Office
Facility Name	BETHESDA HEALTH PHYSICIAN GROUP, INC DBA BAPTIST HEALTH MATERNAL-FETAL MEDICINE BOYNTON BEACH
Street	1325 S CONGRESS AVE SUITE 103
City	BOYNTON BEACH
State	FL
ZIP	33426
Phone	561 364-0200
CertificateType	4
CertificateEffectiveDate	1/10/2023
CertificateExpirationDate	1/9/2025
FacilityType	Waiver

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