10D2174634 CLIA NUMBER - PREMISE HEALTH OF FLORIDA MEDICAL, PA

Laboratory Demographics

CLIA Number: 10D2174634

Facility Name: PREMISE HEALTH OF FLORIDA MEDICAL, PA

Facility Address:
4340 NEWBERRY RD STE 203
GAINESVILLE, FL
ZIP 32607
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Facility Phone Number: 352 663-9196

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1346883196

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	10D2174634
LAB Type	Physician Office
Facility Name	PREMISE HEALTH OF FLORIDA MEDICAL, PA
Street	4340 NEWBERRY RD STE 203
City	GAINESVILLE
State	FL
ZIP	32607
Phone	352 663-9196
CertificateType	4
CertificateEffectiveDate	11/5/2023
CertificateExpirationDate	11/4/2025
FacilityType	Waiver

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