LIFELINE HEALTH, INC.
NPI 1003535469
Clinic/Center - Health Service in Hollywood, FL

Active since August 26, 2022CLIA 10D2167236 · Waiver
1311 N FEDERAL HWY # 1, HOLLYWOOD, FL 33020(888) 202-6052 Get Directions Write a Review

NPPES record last updated: December 14, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 14, 2022, Aug 26, 2022 (2 updates tracked since 2022).

About Lifeline Health, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFELINE HEALTH, INC. (NPI 1003535469) is a healthcare organization registered as a health service in Hollywood, Florida and active in the NPI registry since August 2022. The organization holds a CLIA Waiver certificate valid through June 3, 2027 and lists Gary Kogan, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1003535469
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameLIFELINE HEALTH, INC.
Location Address1311 N FEDERAL HWY # 1Hollywood, FL 33020-3631
Mailing Address1311 N Federal Hwy # 1Hollywood, FL 33020-3631 · (888) 202-6052
Organization SubpartNo
Authorized OfficialGary KoganExecutive Director · (888) 202-6052
Enumeration DateAugust 26, 2022
Last NPPES UpdateDecember 14, 20222 updates tracked since enumeration
NPPES CertifiedDecember 14, 2022
NPI 1003535469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
Also ListedClinic/CenterTaxonomy 261Q00000X
1311 N FEDERAL HWY # 1, Hollywood, FL 33020

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2167236

Lifeline Health, Inc · Hollywood, FL
Active · expires Jun 3, 2027
CLIA Number10D2167236
Laboratory TypeStd/Hiv Testing
Certificate Effective DateJune 4, 2025
Certificate Expiration DateJune 3, 2027
Laboratory DirectorGary G. Kogan
Laboratory Phone(888) 202-6052
Laboratory LocationLifeline Health, Inc1311 N Federal Hwy #1, Hollywood, FL 33020
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lifeline Health, Inc.'s NPI number?

The NPI number for Lifeline Health, Inc. is 1003535469. It was assigned to this organization in the NPPES registry on August 26, 2022.

Where is Lifeline Health, Inc. located?

Lifeline Health, Inc. is located at 1311 N Federal Hwy # 1, Hollywood, FL 33020. The listed phone number is (888) 202-6052.

What is Lifeline Health, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

Does Lifeline Health, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2167236) is associated with this NPI, valid through June 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lifeline Health, Inc. was last updated on December 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.