10D0701822 CLIA NUMBER - CRESTVIEW REHABILITATION CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D0701822
  • Facility Name: CRESTVIEW REHABILITATION CENTER LLC
  • Facility Address: 1849 FIRST AVENUE EAST
    CRESTVIEW, FL
    ZIP 32539
  • Facility Phone: 850 682-5322
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BENJAMIN L. GIDDEN
  • NPI Number: 1821374505
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D0701822
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CRESTVIEW REHABILITATION CENTER LLC
Street 1849 FIRST AVENUE EAST
City CRESTVIEW
State FL
ZIP 32539
Phone 850 682-5322
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director BENJAMIN L. GIDDEN

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This page was last updated on: 9/29/2025