10D2242819 CLIA NUMBER - PROVIDENCE COMMUNITY HEALTH, LLC

Laboratory Demographics

  • CLIA Code: 10D2242819
  • Facility Name: PROVIDENCE COMMUNITY HEALTH, LLC
  • Facility Address: 2150 S CONGRESS AVE
    PALM SPRINGS, FL
    ZIP 33406
  • Facility Phone: (561) 619-3891
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALPHONSE GILOUX DUFRENY
  • NPI Number: 1093471815
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2242819
LAB Type Physician Office
Facility Name PROVIDENCE COMMUNITY HEALTH, LLC
Street 2150 S CONGRESS AVE
City PALM SPRINGS
State FL
ZIP 33406
Phone 5616193891
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2025
Certificate Expiration Date 11/11/2027
Facility Type Physician Office
Lab Director ALPHONSE GILOUX DUFRENY

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This page was last updated on: 5/18/2026