10D0870674 CLIA NUMBER - GLENN M BANKERT DO SHMG

Laboratory Demographics

  • CLIA Code: 10D0870674
  • Facility Name: GLENN M BANKERT DO SHMG
  • Facility Address: 550 W REDSTONE AVE STE 450
    CRESTVIEW, FL
    ZIP 32536
  • Facility Phone: 850 689-2223
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GLENN M. BANKERT
  • NPI Number: 1992736508
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 10D0870674
LAB Type Physician Office
Facility Name GLENN M BANKERT DO SHMG
Street 550 W REDSTONE AVE STE 450
City CRESTVIEW
State FL
ZIP 32536
Phone 850 689-2223
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2023
Certificate Expiration Date 10/17/2025
Facility Type Physician Office
Lab Director GLENN M. BANKERT

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