LAKE CITY VA CLINIC (4441) INSTITUTION (4)

Name	Value
NAME	LAKE CITY VA CLINIC
STATE	FLORIDA
STREET ADDR. 1	484 SOUTHWEST COMMERCE DRIVE
CITY	LAKE CITY
ZIP	32025-1507
OFFICIAL VA NAME	LAKE CITY VA CLINIC
STATUS	National
ASSOCIATIONS	VISN PARENT OF ASSOCIATION: VISN 8 PARENT FACILITY PARENT OF ASSOCIATION: N. FLORIDA/S. GEORGIA HCS
BILLING FACILITY NAME	LAKE CITY VA CLINIC
EFFECTIVE DATE/TIME	2018-10-15 00:00:00 STATUS: ACTIVE NPI: 1437627015
TAXONOMY CODE	Ambulatory Health Care Facilities PRIMARY CODE: YES STATUS: ACTIVE
LOCATION TIMEZONE	EASTERN
COUNTRY	USA
AGENCY CODE	VA
POINTER TO AGENCY	VA
STATION NUMBER	573QK
IDENTIFIER	CODING SYSTEM: CLIA ID: 10D2155445