10D2086854 CLIA NUMBER - NATIONAL MENTOR HEALTHCARE LLC

Home > CLIA Lookup > 10D2086854

Laboratory Demographics

CLIA Number: 10D2086854

Facility Name: NATIONAL MENTOR HEALTHCARE LLC

Facility Address:
1204 W 13TH ST
PANAMA CITY, FL
ZIP 32401
Get Directions

Facility Phone Number: 850 785-0605

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1104238773

Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities
An intermediate care facility providing services for individuals with intellectual disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	10D2086854
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	NATIONAL MENTOR HEALTHCARE LLC
Street	1204 W 13TH ST
City	PANAMA CITY
State	FL
ZIP	32401
Phone	850 785-0605
CertificateType	4
CertificateEffectiveDate	11/13/2022
CertificateExpirationDate	11/12/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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