10D0677852 CLIA NUMBER - PENSACOLA CLUSTER

Laboratory Demographics

CLIA Number: 10D0677852

Facility Name: PENSACOLA CLUSTER

Facility Address:
9460 UNIVERSITY PARKWAY
PENSACOLA, FL
ZIP 32514
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Facility Phone Number: 850 478-2078

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1629475033

Taxonomy: 207RI0200X - Internal Medicine
An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine.

CLIA Record

Field Name	Field Value
CLIA Number	10D0677852
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	PENSACOLA CLUSTER
Street	9460 UNIVERSITY PARKWAY
City	PENSACOLA
State	FL
ZIP	32514
Phone	850 478-2078
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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