10D0959136 CLIA NUMBER - CALVIN BLOUNT JR MD PA

Laboratory Demographics

  • CLIA Code: 10D0959136
  • Facility Name: CALVIN BLOUNT JR MD PA
  • Facility Address: 4012 COMMONS DR W SUITE 120
    DESTIN, FL
    ZIP 32541
  • Facility Phone: 850 837-4844
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CALVIN L. BLOUNT JR MD
  • NPI Number: 1164404588
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D0959136
LAB Type Physician Office
Facility Name CALVIN BLOUNT JR MD PA
Street 4012 COMMONS DR W SUITE 120
City DESTIN
State FL
ZIP 32541
Phone 850 837-4844
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Physician Office
Lab Director CALVIN L. BLOUNT JR MD

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