10D2309999 CLIA NUMBER - DIVINE LAB AND FINGER PRINTING LLC

Laboratory Demographics

  • CLIA Code: 10D2309999
  • Facility Name: DIVINE LAB AND FINGER PRINTING LLC
  • Facility Address: 6067 HOLLYWOOD BLVD #325
    HOLLYWOOD, FL
    ZIP 33024
  • Facility Phone: 954 998-0880
  • Facility Type: Health Main. Organization
  • Facility Type: Waiver
  • Lab Director: STEPHANIE MOMPOINT
  • NPI Number: 1326872326
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 10D2309999
LAB Type Health Main. Organization
Facility Name DIVINE LAB AND FINGER PRINTING LLC
Street 6067 HOLLYWOOD BLVD #325
City HOLLYWOOD
State FL
ZIP 33024
Phone 954 998-0880
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/26/2024
Certificate Expiration Date 8/25/2026
Facility Type Health Main. Organization
Lab Director STEPHANIE MOMPOINT

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