10D1095109 CLIA NUMBER - PENSACOLA BOYS BASE

Laboratory Demographics

  • CLIA Code: 10D1095109
  • Facility Name: PENSACOLA BOYS BASE
  • Facility Address: BLDG 3780 CORRY STATION
    PENSACOLA, FL
    ZIP 32511
  • Facility Phone: 850 453-7490
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: OLIVER JONES
  • NPI Number: 1194822940
  • Taxonomy: 332000000X - Military/U.S. Coast Guard Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 10D1095109
LAB Type Practitioner Other
Facility Name PENSACOLA BOYS BASE
Street BLDG 3780 CORRY STATION
City PENSACOLA
State FL
ZIP 32511
Phone 850 453-7490
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/3/2025
Certificate Expiration Date 2/2/2027
Facility Type Practitioner Other
Lab Director OLIVER JONES

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