10D2204701 CLIA NUMBER - IDEAL CARE MEDICAL CENTER INC

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Laboratory Demographics

CLIA Number: 10D2204701

Facility Name: IDEAL CARE MEDICAL CENTER INC

Facility Address:
2188 S JOG ROAD
GREEN ACRES, FL
ZIP 33415
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Facility Phone Number: 561 429-3777

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1336747179

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D2204701
LAB Type	Physician Office
Facility Name	IDEAL CARE MEDICAL CENTER INC
Street	2188 S JOG ROAD
City	GREEN ACRES
State	FL
ZIP	33415
Phone	561 429-3777
CertificateType	4
CertificateEffectiveDate	12/10/2022
CertificateExpirationDate	12/9/2024
FacilityType	Waiver

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