NPI Details
BANYAN SOBER LIVING, INC. is a clinical medical laboratory in Fort Lauderdale, FL. The provider is (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. BANYAN SOBER LIVING, INC. NPI is 1285978338. The provider is registered as an organization entity type.
The provider's business location address is:
2500 E COMMERCIAL BLVD
SUITE D
FORT LAUDERDALE, FL
ZIP 33308-124
Phone: (954) 746-8232
Fax: (954) 746-8981
The provider's authorized official is Neisha Zaffuto .
The authorized official title is Business Manager and has the following contact phone number (954) 746-8232.
The enumeration date for this NPI number is 11/15/2012 and was last updated on 1/13/2014.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 251S00000X | Community/Behavioral Health | | | | No |
| 2 | 291U00000X | Clinical Medical Laboratory | | 10D2047989 | FLORIDA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 10D2047989 | OTHER | FLORIDA | CLIA CERTIFICATE OF WAIVER |
