10D2082510 CLIA NUMBER - LAKE AMERICA FAMILY PHYSICIANS LLC

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Laboratory Demographics

CLIA Number: 10D2082510

Facility Name: LAKE AMERICA FAMILY PHYSICIANS LLC

Facility Address:
301 FRONTAGE ROAD SUITE G
CLERMONT, FL
ZIP 34711
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Facility Phone Number: 352 432-3939

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1518370147

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	10D2082510
LAB Type	Physician Office
Facility Name	LAKE AMERICA FAMILY PHYSICIANS LLC
Street	301 FRONTAGE ROAD SUITE G
City	CLERMONT
State	FL
ZIP	34711
Phone	352 432-3939
CertificateType	4
CertificateEffectiveDate	8/15/2022
CertificateExpirationDate	8/14/2024
FacilityType	Waiver

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