10D2228699 CLIA NUMBER - SOMA MEDICAL CENTER PA 6

Laboratory Demographics

CLIA Number: 10D2228699

Facility Name: SOMA MEDICAL CENTER PA 6

Facility Address:
4775 N CONGRESS AVE
BOYNTON BEACH, FL
ZIP 33426
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Facility Phone Number: 561 328-8631

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1609449362

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2228699
LAB Type	Physician Office
Facility Name	SOMA MEDICAL CENTER PA 6
Street	4775 N CONGRESS AVE
City	BOYNTON BEACH
State	FL
ZIP	33426
Phone	561 328-8631
CertificateType	4
CertificateEffectiveDate	6/30/2023
CertificateExpirationDate	6/29/2025
FacilityType	Waiver

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