10D2166059 CLIA NUMBER - FIRST PHYSICIANS GROUP FAMILY PRACTICE SOUTH

Laboratory Demographics

  • CLIA Code: 10D2166059
  • Facility Name: FIRST PHYSICIANS GROUP FAMILY PRACTICE SOUTH
  • Facility Address: 395 COMMERCIAL COURT - SUITE A
    VENICE, FL
    ZIP 34292
  • Facility Phone: 941 917-8720
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VICTORIA JOHNSON
  • NPI Number: 1295254555
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2166059
LAB Type Physician Office
Facility Name FIRST PHYSICIANS GROUP FAMILY PRACTICE SOUTH
Street 395 COMMERCIAL COURT - SUITE A
City VENICE
State FL
ZIP 34292
Phone 941 917-8720
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2025
Certificate Expiration Date 5/9/2027
Facility Type Physician Office
Lab Director VICTORIA JOHNSON

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This page was last updated on: 9/29/2025