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10D0870642 CLIA NUMBER - BAILEY FAMILY PRACTICE - NORTHWEST FLORIDA COMMUNITY HOSPITAL

Laboratory Demographics

CLIA Number: 10D0870642

Facility Name: BAILEY FAMILY PRACTICE - NORTHWEST FLORIDA COMMUNITY HOSPITAL

Facility Address:
101 E WISCONSIN AVE
BONIFAY, FL
ZIP 32425
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Facility Phone Number: 850 547-2209

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1043231780

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 10D0870642
LAB Type Physician Office
Facility Name BAILEY FAMILY PRACTICE - NORTHWEST FLORIDA COMMUNITY HOSPITAL
Street 101 E WISCONSIN AVE
City BONIFAY
State FL
ZIP 32425
Phone 850 547-2209
CertificateType 4
CertificateEffectiveDate 9/5/2023
CertificateExpirationDate 9/4/2025
FacilityType Waiver

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