10D2151009 CLIA NUMBER - SANTA ROSA MEDICAL GROUP - OBGYN

Laboratory Demographics

  • CLIA Code: 10D2151009
  • Facility Name: SANTA ROSA MEDICAL GROUP - OBGYN
  • Facility Address: 5595 WOODBINE ROAD
    PACE, FL
    ZIP 32571
  • Facility Phone: 850 981-4497
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALEX STAHURA
  • NPI Number: 1093474637
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2151009
LAB Type Physician Office
Facility Name SANTA ROSA MEDICAL GROUP - OBGYN
Street 5595 WOODBINE ROAD
City PACE
State FL
ZIP 32571
Phone 850 981-4497
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2024
Certificate Expiration Date 7/9/2026
Facility Type Physician Office
Lab Director ALEX STAHURA

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