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

Laboratory Demographics

  • CLIA Code: 10D2193452
  • Facility Name: MIGUEL A GUTIERREZ-DIAZ DO PLLC
  • Facility Address: 4700 BAYOU BLVD SUITE 2C
    PENSACOLA, FL
    ZIP 32503
  • Facility Phone: 850 501-8862
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MIGUEL A. GUTIERREZ-DIAZ
  • NPI Number: 1194777912
  • Taxonomy: 207Q00000X - Family Medicine

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2024
Certificate Expiration Date 9/21/2026
Facility Type Physician Office
Lab Director MIGUEL A. GUTIERREZ-DIAZ

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