10D2310537 CLIA NUMBER - MENTAL HEALTH SERVICES CORP DBA SOUTHWELL HOME HEALTH AGENCY

Laboratory Demographics

  • CLIA Code: 10D2310537
  • Facility Name: MENTAL HEALTH SERVICES CORP DBA SOUTHWELL HOME HEALTH AGENCY
  • Facility Address: 1806 N FLAMINGO ROAD SUITE 347
    PEMBROKE PINES, FL
    ZIP 33028
  • Facility Phone: 954 288-7362
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: SIRAHAYDEE PENA ALCANTARA
  • NPI Number: 1972280121
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 10D2310537
LAB Type Home Health Agency
Facility Name MENTAL HEALTH SERVICES CORP DBA SOUTHWELL HOME HEALTH AGENCY
Street 1806 N FLAMINGO ROAD SUITE 347
City PEMBROKE PINES
State FL
ZIP 33028
Phone 954 288-7362
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2024
Certificate Expiration Date 9/4/2026
Facility Type Home Health Agency
Lab Director SIRAHAYDEE PENA ALCANTARA

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