10D0938919 CLIA NUMBER - INTERVENTIONAL REHABILITATION CENTER LLC DBA PENSACOLA CHILDREN'S SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 10D0938919
  • Facility Name: INTERVENTIONAL REHABILITATION CENTER LLC DBA PENSACOLA CHILDREN'S SURGERY CENTER
  • Facility Address: 1549 N AIRPORT BLVD STE 420
    PENSACOLA, FL
    ZIP 32504
  • Facility Phone: 850 484-8800
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JAMIE L. HEATER
  • NPI Number: 1205839487
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D0938919
LAB Type Ambulatory Surgery Center
Facility Name INTERVENTIONAL REHABILITATION CENTER LLC DBA PENSACOLA CHILDREN'S SURGERY CENTER
Street 1549 N AIRPORT BLVD STE 420
City PENSACOLA
State FL
ZIP 32504
Phone 850 484-8800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/16/2024
Certificate Expiration Date 1/15/2026
Facility Type Ambulatory Surgery Center
Lab Director JAMIE L. HEATER

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