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01D2276549 CLIA NUMBER - SOUTHEAST MEDICAL GROUP DBA LADIGA FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 01D2276549

Facility Name: SOUTHEAST MEDICAL GROUP DBA LADIGA FAMILY MEDICINE

Facility Address:
1460 2ND AVENUE SW, SUITE A
JACKSONVILLE, AL
ZIP 36265
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Facility Phone Number: 770 442-1911

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1376223859

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 01D2276549
LAB Type Physician Office
Facility Name SOUTHEAST MEDICAL GROUP DBA LADIGA FAMILY MEDICINE
Street 1460 2ND AVENUE SW, SUITE A
City JACKSONVILLE
State AL
ZIP 36265
Phone 770 442-1911
CertificateType 4
CertificateEffectiveDate 2/10/2023
CertificateExpirationDate 2/9/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024