14D2065927 CLIA NUMBER - PRIORITY HEALTH FAMILY MEDICINE

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Laboratory Demographics

CLIA Number: 14D2065927

Facility Name: PRIORITY HEALTH FAMILY MEDICINE

Facility Address:
5160 N HICKORY POINT FRONTAGE RD
DECATUR, IL
ZIP 62526
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Facility Phone Number: 217 330-9788

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1598125031

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	14D2065927
LAB Type	Physician Office
Facility Name	PRIORITY HEALTH FAMILY MEDICINE
Street	5160 N HICKORY POINT FRONTAGE RD
City	DECATUR
State	IL
ZIP	62526
Phone	217 330-9788
CertificateType	3
CertificateEffectiveDate	9/17/2023
CertificateExpirationDate	9/16/2025
FacilityType	PPMP

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