10D2102366 CLIA NUMBER - MIDWAY IMMUNOLOGY AND RESEARCH CENTER

Laboratory Demographics

CLIA Number: 10D2102366

Facility Name: MIDWAY IMMUNOLOGY AND RESEARCH CENTER

Facility Address:
360 E MIDWAY RD
FORT PIERCE, FL
ZIP 34982
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Facility Phone Number: 772 595-9830

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1356580518

Taxonomy: 207RI0200X - Internal Medicine
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.

CLIA Record

Field Name	Field Value
CLIA Number	10D2102366
LAB Type	Physician Office
Facility Name	MIDWAY IMMUNOLOGY AND RESEARCH CENTER
Street	360 E MIDWAY RD
City	FORT PIERCE
State	FL
ZIP	34982
Phone	772 595-9830
CertificateType	4
CertificateEffectiveDate	9/22/2023
CertificateExpirationDate	9/21/2025
FacilityType	Waiver

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