10D0984321 CLIA NUMBER - GULF COAST TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 10D0984321
  • Facility Name: GULF COAST TREATMENT CENTER
  • Facility Address: 1015 MAR WALT DR
    FORT WALTON BEACH, FL
    ZIP 32547
  • Facility Phone: 850 863-4160
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: ALEXANDER ADELESBERGER
  • NPI Number: 1013131507
  • Taxonomy: 311Z00000X - Custodial Care Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D0984321
LAB Type Other
Facility Name GULF COAST TREATMENT CENTER
Street 1015 MAR WALT DR
City FORT WALTON BEACH
State FL
ZIP 32547
Phone 850 863-4160
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/20/2025
Certificate Expiration Date 3/19/2027
Facility Type Other
Lab Director ALEXANDER ADELESBERGER

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