10D2172033 CLIA NUMBER - OPTIONS HEALTH FAMILY PRACTICE

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Laboratory Demographics

CLIA Number: 10D2172033

Facility Name: OPTIONS HEALTH FAMILY PRACTICE

Facility Address:
256 CANAL STREET
PORT SAINT JOE, FL
ZIP 32456
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Facility Phone Number: 850 273-8450

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1710583190

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	10D2172033
LAB Type	Physician Office
Facility Name	OPTIONS HEALTH FAMILY PRACTICE
Street	256 CANAL STREET
City	PORT SAINT JOE
State	FL
ZIP	32456
Phone	850 273-8450
CertificateType	4
CertificateEffectiveDate	9/13/2023
CertificateExpirationDate	9/12/2025
FacilityType	Waiver

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