10D2172435 CLIA NUMBER - VIP INTEGRATIVE HEALTH CARE L.L.C

Laboratory Demographics

CLIA Number: 10D2172435

Facility Name: VIP INTEGRATIVE HEALTH CARE L.L.C

Facility Address:
3600 FOREST HILL BLVD STE 3
PALM SPRINGS, FL
ZIP 33406
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Facility Phone Number: 561 909-8555

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1548728280

Taxonomy: 363LP0808X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	10D2172435
LAB Type	Practitioner Other
Facility Name	VIP INTEGRATIVE HEALTH CARE L.L.C
Street	3600 FOREST HILL BLVD STE 3
City	PALM SPRINGS
State	FL
ZIP	33406
Phone	561 909-8555
CertificateType	4
CertificateEffectiveDate	9/24/2023
CertificateExpirationDate	9/23/2025
FacilityType	Waiver

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