10D1091567 CLIA NUMBER - MICHAEL P ROBERTS MD PA

Laboratory Demographics

  • CLIA Code: 10D1091567
  • Facility Name: MICHAEL P ROBERTS MD PA
  • Facility Address: 1001 W COLLEGE BLVD BLDG 1 STE D
    NICEVILLE, FL
    ZIP 32578
  • Facility Phone: 850 389-8333
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL P. ROBERTS
  • NPI Number: 1972691368
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D1091567
LAB Type Physician Office
Facility Name MICHAEL P ROBERTS MD PA
Street 1001 W COLLEGE BLVD BLDG 1 STE D
City NICEVILLE
State FL
ZIP 32578
Phone 850 389-8333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Physician Office
Lab Director MICHAEL P. ROBERTS

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