10D2182060 CLIA NUMBER - PANHANDLE VASCULAR SURGICAL SPECIALISTS

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Laboratory Demographics

CLIA Number: 10D2182060

Facility Name: PANHANDLE VASCULAR SURGICAL SPECIALISTS

Facility Address:
1502 CREIGHTON RD
PENSACOLA, FL
ZIP 32504
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Facility Phone Number: 850 437-3777

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1861929606

Taxonomy: 2086S0129X - Surgery
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

CLIA Record

Field Name	Field Value
CLIA Number	10D2182060
LAB Type	Physician Office
Facility Name	PANHANDLE VASCULAR SURGICAL SPECIALISTS
Street	1502 CREIGHTON RD
City	PENSACOLA
State	FL
ZIP	32504
Phone	850 437-3777
CertificateType	4
CertificateEffectiveDate	4/15/2024
CertificateExpirationDate	4/14/2026
FacilityType	Waiver

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