10D2190717 CLIA NUMBER - SEASIDE PRIMARY CARE AND PSYCHIATRY LLC

Laboratory Demographics

  • CLIA Code: 10D2190717
  • Facility Name: SEASIDE PRIMARY CARE AND PSYCHIATRY LLC
  • Facility Address: 1931 ORTEGA ST
    NAVARRE, FL
    ZIP 32566
  • Facility Phone: 850 736-0026
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: ANGELA D. SANDERS
  • NPI Number: 1730704875
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 10D2190717
LAB Type Practitioner Other
Facility Name SEASIDE PRIMARY CARE AND PSYCHIATRY LLC
Street 1931 ORTEGA ST
City NAVARRE
State FL
ZIP 32566
Phone 850 736-0026
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2024
Certificate Expiration Date 8/17/2026
Facility Type Practitioner Other
Lab Director ANGELA D. SANDERS

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