10D2061005 CLIA NUMBER - GULFPORT NURSING CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D2061005
  • Facility Name: GULFPORT NURSING CENTER LLC
  • Facility Address: 1430 PASADENA AVE S
    SOUTH PASADENA, FL
    ZIP 33707
  • Facility Phone: 727 344-8525
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: W SCOTT RATLIFF
  • NPI Number: 1548995863
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2061005
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name GULFPORT NURSING CENTER LLC
Street 1430 PASADENA AVE S
City SOUTH PASADENA
State FL
ZIP 33707
Phone 727 344-8525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2023
Certificate Expiration Date 11/28/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director W SCOTT RATLIFF

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