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10D0912107 CLIA NUMBER - PEDIATRIC SERVICES OF AMERICA LLC DBA AVEANNA HEALTHCARE

Laboratory Demographics

CLIA Number: 10D0912107

Facility Name: PEDIATRIC SERVICES OF AMERICA LLC DBA AVEANNA HEALTHCARE

Facility Address:
2114 AIRPORT BLVD SUITE 2000
PENSACOLA, FL
ZIP 32504
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Facility Phone Number: 850 444-4365

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1659391944

Taxonomy: 251J00000X - Nursing Care
A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services.

CLIA Record

Field Name Field Value
CLIA Number 10D0912107
LAB Type Home Health Agency
Facility Name PEDIATRIC SERVICES OF AMERICA LLC DBA AVEANNA HEALTHCARE
Street 2114 AIRPORT BLVD SUITE 2000
City PENSACOLA
State FL
ZIP 32504
Phone 850 444-4365
CertificateType 4
CertificateEffectiveDate 9/12/2023
CertificateExpirationDate 9/11/2025
FacilityType Waiver

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