10D1011711 CLIA NUMBER - CORAL BAY AT PENSACOLA, LLC

Laboratory Demographics

CLIA Number: 10D1011711

Facility Name: CORAL BAY AT PENSACOLA, LLC

Facility Address:
600 WEST GREGORY ST
PENSACOLA, FL
ZIP 32502
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Facility Phone Number: 850 434-8071

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1326556200

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	10D1011711
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	CORAL BAY AT PENSACOLA, LLC
Street	600 WEST GREGORY ST
City	PENSACOLA
State	FL
ZIP	32502
Phone	850 434-8071
CertificateType	4
CertificateEffectiveDate	4/18/2023
CertificateExpirationDate	4/17/2025
FacilityType	Waiver

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