10D2133799 CLIA NUMBER - PREMISE HEALTH OF FLORIDA MEDICAL PA

Laboratory Demographics

CLIA Number: 10D2133799

Facility Name: PREMISE HEALTH OF FLORIDA MEDICAL PA

Facility Address:
5245 41ST STREET
VERO BEACH, FL
ZIP 32967
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Facility Phone Number: 772 617-1806

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1659921401

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	10D2133799
LAB Type	Physician Office
Facility Name	PREMISE HEALTH OF FLORIDA MEDICAL PA
Street	5245 41ST STREET
City	VERO BEACH
State	FL
ZIP	32967
Phone	772 617-1806
CertificateType	4
CertificateEffectiveDate	7/20/2023
CertificateExpirationDate	7/19/2025
FacilityType	Waiver

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