10D2145985 CLIA NUMBER - GENESIS COMMUNITY HEALTH, INC ATLANTIC HIGH SCHOOL CLINIC

Laboratory Demographics

CLIA Number: 10D2145985

Facility Name: GENESIS COMMUNITY HEALTH, INC ATLANTIC HIGH SCHOOL CLINIC

Facility Address:
2455 W ATLANTIC AVE
DELRAY BEACH, FL
ZIP 33445
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Facility Phone Number: 561 806-6835

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1871936336

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2145985
LAB Type	Federally Qualified Health Center
Facility Name	GENESIS COMMUNITY HEALTH, INC ATLANTIC HIGH SCHOOL CLINIC
Street	2455 W ATLANTIC AVE
City	DELRAY BEACH
State	FL
ZIP	33445
Phone	561 806-6835
CertificateType	4
CertificateEffectiveDate	3/20/2024
CertificateExpirationDate	3/19/2026
FacilityType	Waiver

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