10D2208339 CLIA NUMBER - SLP HEALTH CARE LLC

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Laboratory Demographics

CLIA Number: 10D2208339

Facility Name: SLP HEALTH CARE LLC

Facility Address:
1371 SE CONFERENCE CIRCLE
STUART, FL
ZIP 34997
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Facility Phone Number: 561 332-2020

Facility Type: Other - PRIARY CARE MOBILE NP

Certificate Type: Waiver

NPI Number: 1104242783

Taxonomy: 363LA2200X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	10D2208339
LAB Type	Other - PRIARY CARE MOBILE NP
Facility Name	SLP HEALTH CARE LLC
Street	1371 SE CONFERENCE CIRCLE
City	STUART
State	FL
ZIP	34997
Phone	561 332-2020
CertificateType	4
CertificateEffectiveDate	1/6/2023
CertificateExpirationDate	1/5/2025
FacilityType	Waiver

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