10D2145095 CLIA NUMBER - BROWARD ENT & AESTHETICS

Laboratory Demographics

CLIA Number: 10D2145095

Facility Name: BROWARD ENT & AESTHETICS

Facility Address:
2307 W BROWARD BLVD STE 201
FORT LAUDERDALE, FL
ZIP 33311
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Facility Phone Number: 954 368-3348

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1760646046

Taxonomy: 207YS0123X - Otolaryngology
An otolaryngologist who specializes in facial plastic surgery.

CLIA Record

Field Name	Field Value
CLIA Number	10D2145095
LAB Type	Physician Office
Facility Name	BROWARD ENT & AESTHETICS
Street	2307 W BROWARD BLVD STE 201
City	FORT LAUDERDALE
State	FL
ZIP	33311
Phone	954 368-3348
CertificateType	4
CertificateEffectiveDate	2/29/2024
CertificateExpirationDate	2/27/2026
FacilityType	Waiver

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