10D2266765 CLIA NUMBER - SOUTH PALM FAMILY CENTER, LLC

Laboratory Demographics

CLIA Number: 10D2266765

Facility Name: SOUTH PALM FAMILY CENTER, LLC

Facility Address:
1701 SE HILLMOOR DRIVE, SUITE B9
PORT SAINT LUCIE, FL
ZIP 34952
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Facility Phone Number: 772 348-0303

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1720746951

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	10D2266765
LAB Type	Physician Office
Facility Name	SOUTH PALM FAMILY CENTER, LLC
Street	1701 SE HILLMOOR DRIVE, SUITE B9
City	PORT SAINT LUCIE
State	FL
ZIP	34952
Phone	772 348-0303
CertificateType	4
CertificateEffectiveDate	8/16/2022
CertificateExpirationDate	8/15/2024
FacilityType	Waiver

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