10D2166517 CLIA NUMBER - SOUTHEAST VASCULAR

Laboratory Demographics

  • CLIA Code: 10D2166517
  • Facility Name: SOUTHEAST VASCULAR
  • Facility Address: 1619 CREIGHTON RD STE 2
    PENSACOLA, FL
    ZIP 32504
  • Facility Phone: 850 429-0102
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAYNE R. YONEHIRO
  • NPI Number: 1295302990
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 10D2166517
LAB Type Physician Office
Facility Name SOUTHEAST VASCULAR
Street 1619 CREIGHTON RD STE 2
City PENSACOLA
State FL
ZIP 32504
Phone 850 429-0102
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type Physician Office
Lab Director LAYNE R. YONEHIRO

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