10D2081063 CLIA NUMBER - ADVANCED GERIATRICS AND PRIMARY CARE

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Laboratory Demographics

CLIA Number: 10D2081063

Facility Name: ADVANCED GERIATRICS AND PRIMARY CARE

Facility Address:
9013 UNIVERSITY PKWY STE G
PENSACOLA, FL
ZIP 32514
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Facility Phone Number: 850 912-8020

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1083027528

Taxonomy: 207QG0300X - Family Medicine
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

CLIA Record

Field Name	Field Value
CLIA Number	10D2081063
LAB Type	Physician Office
Facility Name	ADVANCED GERIATRICS AND PRIMARY CARE
Street	9013 UNIVERSITY PKWY STE G
City	PENSACOLA
State	FL
ZIP	32514
Phone	850 912-8020
CertificateType	4
CertificateEffectiveDate	7/18/2022
CertificateExpirationDate	7/17/2024
FacilityType	Waiver

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