10D2291402 CLIA NUMBER - PROVIDIA HOME CARE OF PALM BEACH LLC

Laboratory Demographics

  • CLIA Code: 10D2291402
  • Facility Name: PROVIDIA HOME CARE OF PALM BEACH LLC
  • Facility Address: 1103 N PARROTT AVENUE
    OKEECHOBEE, FL
    ZIP 34972
  • Facility Phone: 239 425-2670
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: MIRANDA REDISH
  • NPI Number: 1710343900
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 10D2291402
LAB Type Home Health Agency
Facility Name PROVIDIA HOME CARE OF PALM BEACH LLC
Street 1103 N PARROTT AVENUE
City OKEECHOBEE
State FL
ZIP 34972
Phone 239 425-2670
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2023
Certificate Expiration Date 10/9/2025
Facility Type Home Health Agency
Lab Director MIRANDA REDISH

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