10D2227939 CLIA NUMBER - ALL FAMILY WALK-IN CLINIC LLC

Laboratory Demographics

CLIA Number: 10D2227939

Facility Name: ALL FAMILY WALK-IN CLINIC LLC

Facility Address:
13462 TAFT ST
BROOKSVILLE, FL
ZIP 34613
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Facility Phone Number: 724 591-4725

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1558948455

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	10D2227939
LAB Type	Practitioner Other
Facility Name	ALL FAMILY WALK-IN CLINIC LLC
Street	13462 TAFT ST
City	BROOKSVILLE
State	FL
ZIP	34613
Phone	724 591-4725
CertificateType	4
CertificateEffectiveDate	6/18/2023
CertificateExpirationDate	6/17/2025
FacilityType	Waiver

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