10D2110241 CLIA NUMBER - SACRED HEART MEDICAL GROUP

Laboratory Demographics

CLIA Number: 10D2110241

Facility Name: SACRED HEART MEDICAL GROUP

Facility Address:
151 MAIN ST STE 101
PENSACOLA, FL
ZIP 32502
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Facility Phone Number: 850 416-7544

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1609542448

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D2110241
LAB Type	Physician Office
Facility Name	SACRED HEART MEDICAL GROUP
Street	151 MAIN ST STE 101
City	PENSACOLA
State	FL
ZIP	32502
Phone	850 416-7544
CertificateType	4
CertificateEffectiveDate	3/10/2024
CertificateExpirationDate	3/9/2026
FacilityType	Waiver

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