10D2276025 CLIA NUMBER - CLEMENTINE PALMETTO BAY

Laboratory Demographics

  • CLIA Code: 10D2276025
  • Facility Name: CLEMENTINE PALMETTO BAY
  • Facility Address: 7201 SW 174TH STREET
    PALMETTO BAY, FL
    ZIP 33157
  • Facility Phone: 786 809-3600
  • Facility Type: Other - RESIDENTIAL TREATMENT CEN
  • Facility Type: Waiver
  • Lab Director: MOLLY M. PERLMAN
  • NPI Number: 1154589687
  • Taxonomy: 323P00000X - Psychiatric Residential Treatment Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2276025
LAB Type Other - RESIDENTIAL TREATMENT CEN
Facility Name CLEMENTINE PALMETTO BAY
Street 7201 SW 174TH STREET
City PALMETTO BAY
State FL
ZIP 33157
Phone 786 809-3600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2025
Certificate Expiration Date 1/31/2027
Facility Type Other - RESIDENTIAL TREATMENT CEN
Lab Director MOLLY M. PERLMAN

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