10D1017165 CLIA NUMBER - KEITH BANTON MD PA

Laboratory Demographics

CLIA Number: 10D1017165

Facility Name: KEITH BANTON MD PA

Facility Address:
1937 HARRISON AVE
PANAMA CITY, FL
ZIP 32405
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Facility Phone Number: 850 763-4700

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1205896636

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	10D1017165
LAB Type	Physician Office
Facility Name	KEITH BANTON MD PA
Street	1937 HARRISON AVE
City	PANAMA CITY
State	FL
ZIP	32405
Phone	850 763-4700
CertificateType	4
CertificateEffectiveDate	9/18/2023
CertificateExpirationDate	9/17/2025
FacilityType	Waiver

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