10D2196773 CLIA NUMBER - ASSISTED LIVING OF BROWARD

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Laboratory Demographics

CLIA Number: 10D2196773

Facility Name: ASSISTED LIVING OF BROWARD

Facility Address:
17646 SW 10TH ST
PEMBROKE PINES, FL
ZIP 33029
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Facility Phone Number: 954 214-7926

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1104127315

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	10D2196773
LAB Type	Assisted Living Facility
Facility Name	ASSISTED LIVING OF BROWARD
Street	17646 SW 10TH ST
City	PEMBROKE PINES
State	FL
ZIP	33029
Phone	954 214-7926
CertificateType	4
CertificateEffectiveDate	10/20/2022
CertificateExpirationDate	10/19/2024
FacilityType	Waiver

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