10D2031175 CLIA NUMBER - CREEKSIDE FAMILY PRACTICE

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Laboratory Demographics

CLIA Number: 10D2031175

Facility Name: CREEKSIDE FAMILY PRACTICE

Facility Address:
1265 CREEKSIDE PARKWAY SUITE 206
NAPLES, FL
ZIP 34108
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Facility Phone Number: 239 658-3131

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1063793214

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	10D2031175
LAB Type	Federally Qualified Health Center
Facility Name	CREEKSIDE FAMILY PRACTICE
Street	1265 CREEKSIDE PARKWAY SUITE 206
City	NAPLES
State	FL
ZIP	34108
Phone	239 658-3131
CertificateType	4
CertificateEffectiveDate	10/14/2023
CertificateExpirationDate	10/13/2025
FacilityType	Waiver

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