10D2184396 CLIA NUMBER - CONCIERGE HEALTH & REJUVENATION SOLUTIONS

Laboratory Demographics

CLIA Number: 10D2184396

Facility Name: CONCIERGE HEALTH & REJUVENATION SOLUTIONS

Facility Address:
7025 BERACASA WAY STE 205
BOCA RATON, FL
ZIP 33433
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Facility Phone Number: 561 292-0036

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1760009138

Taxonomy: 363LA2200X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	10D2184396
LAB Type	Practitioner Other
Facility Name	CONCIERGE HEALTH & REJUVENATION SOLUTIONS
Street	7025 BERACASA WAY STE 205
City	BOCA RATON
State	FL
ZIP	33433
Phone	561 292-0036
CertificateType	4
CertificateEffectiveDate	5/19/2022
CertificateExpirationDate	5/18/2024
FacilityType	Waiver

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