10D0989864 CLIA NUMBER - SACRED HEART MEDICAL GROUP

Laboratory Demographics

CLIA Number: 10D0989864

Facility Name: SACRED HEART MEDICAL GROUP

Facility Address:
1549 AIRPORT BLVD STE 340
PENSACOLA, FL
ZIP 32504
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Facility Phone Number: 850 416-2340

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1124799671

Taxonomy: 207RE0101X - Internal Medicine
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.

CLIA Record

Field Name	Field Value
CLIA Number	10D0989864
LAB Type	Physician Office
Facility Name	SACRED HEART MEDICAL GROUP
Street	1549 AIRPORT BLVD STE 340
City	PENSACOLA
State	FL
ZIP	32504
Phone	850 416-2340
CertificateType	4
CertificateEffectiveDate	8/8/2023
CertificateExpirationDate	8/7/2025
FacilityType	Waiver

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