10D2066542 CLIA NUMBER - HISPANIC HEALTH ENTERPRISES LLC

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Laboratory Demographics

CLIA Number: 10D2066542

Facility Name: HISPANIC HEALTH ENTERPRISES LLC

Facility Address:
4990 GOLDEN GATE PKWY STE 2
NAPLES, FL
ZIP 34116
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Facility Phone Number: 239 692-8309

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1477801942

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	10D2066542
LAB Type	Physician Office
Facility Name	HISPANIC HEALTH ENTERPRISES LLC
Street	4990 GOLDEN GATE PKWY STE 2
City	NAPLES
State	FL
ZIP	34116
Phone	239 692-8309
CertificateType	4
CertificateEffectiveDate	9/27/2023
CertificateExpirationDate	9/26/2025
FacilityType	Waiver

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