10D2255698 CLIA NUMBER - VIP FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 10D2255698

Facility Name: VIP FAMILY PRACTICE

Facility Address:
1192 CYPRESS GLENN CIR
KISSIMMEE, FL
ZIP 34741
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Facility Phone Number: 407 674-2044

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1669725552

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	10D2255698
LAB Type	Physician Office
Facility Name	VIP FAMILY PRACTICE
Street	1192 CYPRESS GLENN CIR
City	KISSIMMEE
State	FL
ZIP	34741
Phone	407 674-2044
CertificateType	4
CertificateEffectiveDate	3/16/2024
CertificateExpirationDate	3/15/2026
FacilityType	Waiver

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