10D2206565 CLIA NUMBER - SEAGRASS PCB MC LLC

Laboratory Demographics

  • CLIA Code: 10D2206565
  • Facility Name: SEAGRASS PCB MC LLC
  • Facility Address: 401 N ALF COLEMAN RD
    PANAMA CITY BEACH, FL
    ZIP 32407
  • Facility Phone: 850 249-0707
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: ELLEN WITTERSTAETER
  • NPI Number: 1003374455
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 10D2206565
LAB Type Assisted Living Facility
Facility Name SEAGRASS PCB MC LLC
Street 401 N ALF COLEMAN RD
City PANAMA CITY BEACH
State FL
ZIP 32407
Phone 850 249-0707
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Assisted Living Facility
Lab Director ELLEN WITTERSTAETER

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