10D0878985 CLIA NUMBER - GRAND BOULEVARD HEALTH AND REHAB

Laboratory Demographics

  • CLIA Code: 10D0878985
  • Facility Name: GRAND BOULEVARD HEALTH AND REHAB
  • Facility Address: 138 SANDESTIN LANE
    MIRAMAR BEACH, FL
    ZIP 32550
  • Facility Phone: 850 267-2887
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BRENT HAZEN
  • NPI Number: 1386804599
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D0878985
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GRAND BOULEVARD HEALTH AND REHAB
Street 138 SANDESTIN LANE
City MIRAMAR BEACH
State FL
ZIP 32550
Phone 850 267-2887
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2023
Certificate Expiration Date 11/8/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director BRENT HAZEN

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