10D2248022 CLIA NUMBER - ADVANCED CARE CONSULTANTS, LLC

Laboratory Demographics

CLIA Number: 10D2248022

Facility Name: ADVANCED CARE CONSULTANTS, LLC

Facility Address:
5944 CORAL RIDGE 268
CORAL SPRINGS, FL
ZIP 33076
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Facility Phone Number: 888 701-4161

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1003587361

Taxonomy: 363LP0808X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	10D2248022
LAB Type	Practitioner Other
Facility Name	ADVANCED CARE CONSULTANTS, LLC
Street	5944 CORAL RIDGE 268
City	CORAL SPRINGS
State	FL
ZIP	33076
Phone	888 701-4161
CertificateType	4
CertificateEffectiveDate	1/11/2024
CertificateExpirationDate	1/10/2026
FacilityType	Waiver

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