10D2057880 CLIA NUMBER - SONI FAMILY PRACTICE

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Laboratory Demographics

CLIA Number: 10D2057880

Facility Name: SONI FAMILY PRACTICE

Facility Address:
106 PARK PLACE BLVE STE C
DAVENPORT, FL
ZIP 33837
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Facility Phone Number: 863 588-4775

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1083957583

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	10D2057880
LAB Type	Physician Office
Facility Name	SONI FAMILY PRACTICE
Street	106 PARK PLACE BLVE STE C
City	DAVENPORT
State	FL
ZIP	33837
Phone	863 588-4775
CertificateType	4
CertificateEffectiveDate	4/25/2023
CertificateExpirationDate	4/24/2025
FacilityType	Waiver

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