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25D2068935 CLIA NUMBER - ST DOMINIC'S FAMILY MEDICINE - BRANDON

Laboratory Demographics

CLIA Number: 25D2068935

Facility Name: ST DOMINIC'S FAMILY MEDICINE - BRANDON

Facility Address:
1297 WEST GOVERNMENT STREET
BRANDON, MS
ZIP 39042
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Facility Phone Number: 601 200-3790

Facility Type: Physician Office

Certificate Type: Certificate of Compliance
NPI Number: 1548698608

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 25D2068935
LAB Type Physician Office
Facility Name ST DOMINIC'S FAMILY MEDICINE - BRANDON
Street 1297 WEST GOVERNMENT STREET
City BRANDON
State MS
ZIP 39042
Phone 601 200-3790
CertificateType 2
CertificateEffectiveDate 5/15/2024
CertificateExpirationDate 5/14/2026
FacilityType Compliance

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