10D2267311 CLIA NUMBER - PORTABLE MEDICAL DIAGNOSTICS, INC

Laboratory Demographics

CLIA Code: 10D2267311
Facility Name: PORTABLE MEDICAL DIAGNOSTICS, INC
Facility Address: 3540 FOREST HILL BLVD. STE. 112
WEST PALM BEACH, FL
ZIP 33406
Facility Phone: 561 964-3311
Facility Type: Other - TEMP SITE/ PORTABLE LAB
Facility Type: Waiver
Lab Director: ANDREW C. ROSEBROUGH
NPI Number: 1093759276
Taxonomy: 335V00000X - Portable X-ray and/or Other Portable Diagnostic Imaging Supplier

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CLIA Record

Field Name	Field Value
CLIA Number	10D2267311
LAB Type	Other - TEMP SITE/ PORTABLE LAB
Facility Name	PORTABLE MEDICAL DIAGNOSTICS, INC
Street	3540 FOREST HILL BLVD. STE. 112
City	WEST PALM BEACH
State	FL
ZIP	33406
Phone	561 964-3311
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	8/23/2024
Certificate Expiration Date	8/22/2026
Facility Type	Other - TEMP SITE/ PORTABLE LAB
Lab Director	ANDREW C. ROSEBROUGH

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