10D2260518 CLIA NUMBER - POVERELLO CENTER, THE

Laboratory Demographics

  • CLIA Code: 10D2260518
  • Facility Name: POVERELLO CENTER, THE
  • Facility Address: 2056 N DIXIE HWY
    WILTON MANORS, FL
    ZIP 33305
  • Facility Phone: 954 213-6597
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: JAMES N. LUCKETTE JR
  • NPI Number: 1821021361
  • Taxonomy: 251V00000X - Voluntary or Charitable

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CLIA Record

Field Name Field Value
CLIA Number 10D2260518
LAB Type Community Clinic
Facility Name POVERELLO CENTER, THE
Street 2056 N DIXIE HWY
City WILTON MANORS
State FL
ZIP 33305
Phone 954 213-6597
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/19/2024
Certificate Expiration Date 5/18/2026
Facility Type Community Clinic
Lab Director JAMES N. LUCKETTE JR

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