Provider Demographics
NPI:1447987532
Name:CLEAR CHOICE DIAGNOSTICS INC
Entity type:Organization
Organization Name:CLEAR CHOICE DIAGNOSTICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-337-4356
Mailing Address - Street 1:6699 N FEDERAL HWY STE 105
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1660
Mailing Address - Country:US
Mailing Address - Phone:561-337-4356
Mailing Address - Fax:561-419-6315
Practice Address - Street 1:6699 N FEDERAL HWY STE 105
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1660
Practice Address - Country:US
Practice Address - Phone:561-337-4356
Practice Address - Fax:561-419-6315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-08
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory