10D2158101 CLIA NUMBER - CONVIVA MEDICAL CENTER MANAGEMENT LLC DBA CONVIVA CARE CENTER

Laboratory Demographics

  • CLIA Code: 10D2158101
  • Facility Name: CONVIVA MEDICAL CENTER MANAGEMENT LLC DBA CONVIVA CARE CENTER
  • Facility Address: 1500 EAST HILLSBORO BLVD, STE 107
    DEERFIELD BEACH, FL
    ZIP 33441
  • Facility Phone: 954 600-1368
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROMEO R. LEGASPI
  • NPI Number: 1417600636
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2158101
LAB Type Physician Office
Facility Name CONVIVA MEDICAL CENTER MANAGEMENT LLC DBA CONVIVA CARE CENTER
Street 1500 EAST HILLSBORO BLVD, STE 107
City DEERFIELD BEACH
State FL
ZIP 33441
Phone 954 600-1368
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2024
Certificate Expiration Date 11/19/2026
Facility Type Physician Office
Lab Director ROMEO R. LEGASPI

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This page was last updated on: 9/29/2025