10D0968096 CLIA NUMBER - MICHAEL G DEGNAN LLC

Laboratory Demographics

CLIA Number: 10D0968096

Facility Name: MICHAEL G DEGNAN LLC

Facility Address:
181 WEBB DR STE A
DAVENPORT, FL
ZIP 33837
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Facility Phone Number: 863 419-1235

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1902802572

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	10D0968096
LAB Type	Physician Office
Facility Name	MICHAEL G DEGNAN LLC
Street	181 WEBB DR STE A
City	DAVENPORT
State	FL
ZIP	33837
Phone	863 419-1235
CertificateType	4
CertificateEffectiveDate	2/17/2024
CertificateExpirationDate	2/16/2026
FacilityType	Waiver

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