10D0947915 CLIA NUMBER - BONITA FAMILY CARE

Laboratory Demographics

CLIA Number: 10D0947915

Facility Name: BONITA FAMILY CARE

Facility Address:
10459 REYNOLDS STREET
BONITA SPRINGS, FL
ZIP 34135
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Facility Phone Number: 941 992-4344

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1902912850

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	10D0947915
LAB Type	Physician Office
Facility Name	BONITA FAMILY CARE
Street	10459 REYNOLDS STREET
City	BONITA SPRINGS
State	FL
ZIP	34135
Phone	941 992-4344
CertificateType	4
CertificateEffectiveDate	6/26/2022
CertificateExpirationDate	6/25/2024
FacilityType	Waiver

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