10D2116681 CLIA NUMBER - ENGLEWOOD COMMUNITY CARE CLINIC

Laboratory Demographics

CLIA Number: 10D2116681

Facility Name: ENGLEWOOD COMMUNITY CARE CLINIC

Facility Address:
6868 SAN CASA DR
ENGLEWOOD, FL
ZIP 34224
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Facility Phone Number: 941 681-3765

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1184831430

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	10D2116681
LAB Type	Community Clinic
Facility Name	ENGLEWOOD COMMUNITY CARE CLINIC
Street	6868 SAN CASA DR
City	ENGLEWOOD
State	FL
ZIP	34224
Phone	941 681-3765
CertificateType	4
CertificateEffectiveDate	7/29/2022
CertificateExpirationDate	7/28/2024
FacilityType	Waiver

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