10D1052527 CLIA NUMBER - BLUEWATER RADIOLOGY, PLLC

Laboratory Demographics

  • CLIA Code: 10D1052527
  • Facility Name: BLUEWATER RADIOLOGY, PLLC
  • Facility Address: 4536 HWY 20 E
    NICEVILLE, FL
    ZIP 32578
  • Facility Phone: 850 729-6747
  • Facility Type: Other - RADIOLOGY IMAGINF
  • Facility Type: Waiver
  • Lab Director: ROSS W. BARNETT
  • NPI Number: 1073158481
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 10D1052527
LAB Type Other - RADIOLOGY IMAGINF
Facility Name BLUEWATER RADIOLOGY, PLLC
Street 4536 HWY 20 E
City NICEVILLE
State FL
ZIP 32578
Phone 850 729-6747
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2024
Certificate Expiration Date 7/12/2026
Facility Type Other - RADIOLOGY IMAGINF
Lab Director ROSS W. BARNETT

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