10D2271077 CLIA NUMBER - PLANTATION GYNECOLOGY LLC

Laboratory Demographics

  • CLIA Code: 10D2271077
  • Facility Name: PLANTATION GYNECOLOGY LLC
  • Facility Address: 201 NW 82ND AVENUE SUITE 103
    PLANTATION, FL
    ZIP 33324
  • Facility Phone: 954 473-2011
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK GRENITZ
  • NPI Number: 1205877719
  • Taxonomy: 2086S0120X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 10D2271077
LAB Type Physician Office
Facility Name PLANTATION GYNECOLOGY LLC
Street 201 NW 82ND AVENUE SUITE 103
City PLANTATION
State FL
ZIP 33324
Phone 954 473-2011
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2024
Certificate Expiration Date 10/26/2026
Facility Type Physician Office
Lab Director MARK GRENITZ

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This page was last updated on: 6/4/2025