10D0976727 CLIA NUMBER - HAILE MEDICAL GROUP PA

Laboratory Demographics

CLIA Number: 10D0976727

Facility Name: HAILE MEDICAL GROUP PA

Facility Address:
4750 SW 91 DRIVE SUITE A
GAINESVILLE, FL
ZIP 32608
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Facility Phone Number: 352 367-9602

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1851433197

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	10D0976727
LAB Type	Physician Office
Facility Name	HAILE MEDICAL GROUP PA
Street	4750 SW 91 DRIVE SUITE A
City	GAINESVILLE
State	FL
ZIP	32608
Phone	352 367-9602
CertificateType	4
CertificateEffectiveDate	8/14/2022
CertificateExpirationDate	8/13/2024
FacilityType	Waiver

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