08D2260364 CLIA NUMBER - HOLISTIC FAMILY MEDICAL PRACTICE, LLC

Laboratory Demographics

CLIA Number: 08D2260364

Facility Name: HOLISTIC FAMILY MEDICAL PRACTICE, LLC

Facility Address:
262 CHAPMAN ROAD STE 107
NEWARK, DE
ZIP 19702
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Facility Phone Number: 267 879-6292

Facility Type: Practitioner Other

Certificate Type: Microscopy

NPI Number: 1184369936

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	08D2260364
LAB Type	Practitioner Other
Facility Name	HOLISTIC FAMILY MEDICAL PRACTICE, LLC
Street	262 CHAPMAN ROAD STE 107
City	NEWARK
State	DE
ZIP	19702
Phone	267 879-6292
CertificateType	3
CertificateEffectiveDate	5/18/2022
CertificateExpirationDate	5/17/2024
FacilityType	PPMP

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