49D2236398 CLIA NUMBER - MILLS FAMILY PRACTICE LLC

Laboratory Demographics

CLIA Number: 49D2236398

Facility Name: MILLS FAMILY PRACTICE LLC

Facility Address:
1320 SEYMOUR DRIVE
SOUTH BOSTON, VA
ZIP 24592
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Facility Phone Number: 434 579-0069

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1205505344

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	49D2236398
LAB Type	Physician Office
Facility Name	MILLS FAMILY PRACTICE LLC
Street	1320 SEYMOUR DRIVE
City	SOUTH BOSTON
State	VA
ZIP	24592
Phone	434 579-0069
CertificateType	4
CertificateEffectiveDate	9/16/2023
CertificateExpirationDate	9/15/2025
FacilityType	Waiver

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