10D0875450 CLIA NUMBER - NORTHWEST FLORIDA ASC LP

Laboratory Demographics

  • CLIA Code: 10D0875450
  • Facility Name: NORTHWEST FLORIDA ASC LP
  • Facility Address: 204 B EAST 19TH STREET
    PANAMA CITY, FL
    ZIP 32405
  • Facility Phone: 850 769-7599
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: SUDHAKAR REDDY
  • NPI Number: 1992785232
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D0875450
LAB Type Ambulatory Surgery Center
Facility Name NORTHWEST FLORIDA ASC LP
Street 204 B EAST 19TH STREET
City PANAMA CITY
State FL
ZIP 32405
Phone 850 769-7599
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2025
Certificate Expiration Date 8/22/2027
Facility Type Ambulatory Surgery Center
Lab Director SUDHAKAR REDDY

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