10D2165250 CLIA NUMBER - ELITE WOMEN'S CARE

Laboratory Demographics

CLIA Number: 10D2165250

Facility Name: ELITE WOMEN'S CARE

Facility Address:
11317 CORTEZ BLVD
BROOKSVILLE, FL
ZIP 34613
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Facility Phone Number: 352 345-4456

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1336702109

Taxonomy: 207VG0400X - Obstetrics & Gynecology
A physician who specializes in diagnosis, treatment, and management of patients with gynecologic conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	10D2165250
LAB Type	Physician Office
Facility Name	ELITE WOMEN'S CARE
Street	11317 CORTEZ BLVD
City	BROOKSVILLE
State	FL
ZIP	34613
Phone	352 345-4456
CertificateType	4
CertificateEffectiveDate	4/23/2023
CertificateExpirationDate	4/22/2025
FacilityType	Waiver

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