10D2240320 CLIA NUMBER - PASSPORT HEALTH

Laboratory Demographics

  • CLIA Code: 10D2240320
  • Facility Name: PASSPORT HEALTH
  • Facility Address: 7700 CONGRESS AVENUE #1102
    BOCA RATON, FL
    ZIP 33487
  • Facility Phone: 480 646-9028
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WALTER B. KANE
  • NPI Number: 1104524925
  • Taxonomy: 172V00000X - Community Health Worker

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CLIA Record

Field Name Field Value
CLIA Number 10D2240320
LAB Type Physician Office
Facility Name PASSPORT HEALTH
Street 7700 CONGRESS AVENUE #1102
City BOCA RATON
State FL
ZIP 33487
Phone 480 646-9028
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2023
Certificate Expiration Date 10/18/2025
Facility Type Physician Office
Lab Director WALTER B. KANE

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This page was last updated on: 9/29/2025