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

Laboratory Demographics

  • CLIA Code: 10D0870642
  • Facility Name: BAILEY FAMILY PRACTICE - NORTHWEST FLORIDA COMMUNITY HOSPITAL
  • Facility Address: 101 E WISCONSIN AVE
    BONIFAY, FL
    ZIP 32425
  • Facility Phone: 850 547-2209
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LEISA H. BAILEY
  • NPI Number: 1043231780
  • Taxonomy: 207Q00000X - Family Medicine

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/5/2025
Certificate Expiration Date 9/4/2027
Facility Type Physician Office
Lab Director LEISA H. BAILEY

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This page was last updated on: 9/29/2025