10D2145679 CLIA NUMBER - NORTH FLORIDA SURGEONS NORTHWEST FLORIDA ENT LLC

Laboratory Demographics

  • CLIA Code: 10D2145679
  • Facility Name: NORTH FLORIDA SURGEONS NORTHWEST FLORIDA ENT LLC
  • Facility Address: 310 RACETRACK ROAD NW
    FT WALTON BEACH, FL
    ZIP 32547
  • Facility Phone: 850 889-4550
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JASON R. BOOLE
  • NPI Number: 1821466491
  • Taxonomy: 207Y00000X - Otolaryngology

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CLIA Record

Field Name Field Value
CLIA Number 10D2145679
LAB Type Physician Office
Facility Name NORTH FLORIDA SURGEONS NORTHWEST FLORIDA ENT LLC
Street 310 RACETRACK ROAD NW
City FT WALTON BEACH
State FL
ZIP 32547
Phone 850 889-4550
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/13/2024
Certificate Expiration Date 3/12/2026
Facility Type Physician Office
Lab Director JASON R. BOOLE

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