10D0974058 CLIA NUMBER - INTERCOASTAL FAMILY PRATICE

Laboratory Demographics

CLIA Number: 10D0974058

Facility Name: INTERCOASTAL FAMILY PRATICE

Facility Address:
943 S BENEVA ROAD SUITE 204
SARASOTA, FL
ZIP 34232
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Facility Phone Number: 941 953-5213

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1306516208

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	10D0974058
LAB Type	Physician Office
Facility Name	INTERCOASTAL FAMILY PRATICE
Street	943 S BENEVA ROAD SUITE 204
City	SARASOTA
State	FL
ZIP	34232
Phone	941 953-5213
CertificateType	4
CertificateEffectiveDate	5/25/2022
CertificateExpirationDate	5/24/2024
FacilityType	Waiver

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