10D2070821 CLIA NUMBER - WILLISTON RURAL HEALTH AND WELLNESS CENTER

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Laboratory Demographics

CLIA Number: 10D2070821

Facility Name: WILLISTON RURAL HEALTH AND WELLNESS CENTER

Facility Address:
300 A NW 1ST AVE
WILLISTON, FL
ZIP 32696
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Facility Phone Number: 352 529-0966

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1952712713

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2070821
LAB Type	Rural Health Clinic
Facility Name	WILLISTON RURAL HEALTH AND WELLNESS CENTER
Street	300 A NW 1ST AVE
City	WILLISTON
State	FL
ZIP	32696
Phone	352 529-0966
CertificateType	4
CertificateEffectiveDate	12/26/2023
CertificateExpirationDate	12/25/2025
FacilityType	Waiver

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