10D2088122 CLIA NUMBER - COASTAL COMPLETE CARE

Laboratory Demographics

  • CLIA Code: 10D2088122
  • Facility Name: COASTAL COMPLETE CARE
  • Facility Address: 100 PLANTATION RD
    PERRY, FL
    ZIP 32348
  • Facility Phone: 850 584-6000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DIANE DODGEN
  • NPI Number: 1720483043
  • Taxonomy: 111N00000X - Chiropractor

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 10D2088122
LAB Type Physician Office
Facility Name COASTAL COMPLETE CARE
Street 100 PLANTATION RD
City PERRY
State FL
ZIP 32348
Phone 850 584-6000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2024
Certificate Expiration Date 12/10/2026
Facility Type Physician Office
Lab Director DIANE DODGEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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