10D0271510 CLIA NUMBER - MAGNOLIA MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 10D0271510

Facility Name: MAGNOLIA MEDICAL CLINIC

Facility Address:
319 GREEN ACRES RD STE 101
FORT WALTON BEACH, FL
ZIP 32547
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Facility Phone Number: 850 243-7681

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1639281652

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	10D0271510
LAB Type	Physician Office
Facility Name	MAGNOLIA MEDICAL CLINIC
Street	319 GREEN ACRES RD STE 101
City	FORT WALTON BEACH
State	FL
ZIP	32547
Phone	850 243-7681
CertificateType	1
CertificateEffectiveDate	7/12/2023
CertificateExpirationDate	7/11/2025
FacilityType	Accreditation

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