45D0477708 CLIA NUMBER - ADAM S MINER, MD DBA PROMENADE FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 45D0477708

Facility Name: ADAM S MINER, MD DBA PROMENADE FAMILY MEDICINE

Facility Address:
1120 W CAMPBELL ROAD, SUITE 111
RICHARDSON, TX
ZIP 75080
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Facility Phone Number: 972 234-6868

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1467454603

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	45D0477708
LAB Type	Physician Office
Facility Name	ADAM S MINER, MD DBA PROMENADE FAMILY MEDICINE
Street	1120 W CAMPBELL ROAD, SUITE 111
City	RICHARDSON
State	TX
ZIP	75080
Phone	972 234-6868
CertificateType	3
CertificateEffectiveDate	3/7/2024
CertificateExpirationDate	3/6/2026
FacilityType	PPMP

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