10D0705757 CLIA NUMBER - ALLIANCE FAMILY PHYSICIANS PA

Laboratory Demographics

CLIA Number: 10D0705757

Facility Name: ALLIANCE FAMILY PHYSICIANS PA

Facility Address:
4611 NW 53RD AVENUE
GAINESVILLE, FL
ZIP 32653
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Facility Phone Number: 352 371-0301

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1245289206

Taxonomy: 207QA0505X - Family Medicine
The National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code.

CLIA Record

Field Name	Field Value
CLIA Number	10D0705757
LAB Type	Physician Office
Facility Name	ALLIANCE FAMILY PHYSICIANS PA
Street	4611 NW 53RD AVENUE
City	GAINESVILLE
State	FL
ZIP	32653
Phone	352 371-0301
CertificateType	4
CertificateEffectiveDate	12/1/2023
CertificateExpirationDate	11/30/2025
FacilityType	Waiver

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