10D2193452 CLIA NUMBER - MIGUEL A GUTIERREZ-DIAZ DO PLLC

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Laboratory Demographics

CLIA Number: 10D2193452

Facility Name: MIGUEL A GUTIERREZ-DIAZ DO PLLC

Facility Address:
4700 BAYOU BLVD SUITE 2C
PENSACOLA, FL
ZIP 32503
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Facility Phone Number: 850 501-8862

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1194777912

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	10D2193452
LAB Type	Physician Office
Facility Name	MIGUEL A GUTIERREZ-DIAZ DO PLLC
Street	4700 BAYOU BLVD SUITE 2C
City	PENSACOLA
State	FL
ZIP	32503
Phone	850 501-8862
CertificateType	4
CertificateEffectiveDate	9/22/2022
CertificateExpirationDate	9/21/2024
FacilityType	Waiver

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