10D2204765 CLIA NUMBER - BLUE ZONE HEALTH LLC

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Laboratory Demographics

CLIA Number: 10D2204765

Facility Name: BLUE ZONE HEALTH LLC

Facility Address:
1000 N OLIVE AVE
WEST PALM BEACH, FL
ZIP 33401
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Facility Phone Number: 561 557-1767

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1982001277

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2204765
LAB Type	Physician Office
Facility Name	BLUE ZONE HEALTH LLC
Street	1000 N OLIVE AVE
City	WEST PALM BEACH
State	FL
ZIP	33401
Phone	561 557-1767
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