10D2214396 CLIA NUMBER - GUSTAVO F ROS MD PA

Laboratory Demographics

  • CLIA Code: 10D2214396
  • Facility Name: GUSTAVO F ROS MD PA
  • Facility Address: 914 MARWALT DR STE C
    FORT WALTON BEACH, FL
    ZIP 32547
  • Facility Phone: 850 863-3199
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GUSTAVO F. ROS
  • NPI Number: 1548754963
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 10D2214396
LAB Type Physician Office
Facility Name GUSTAVO F ROS MD PA
Street 914 MARWALT DR STE C
City FORT WALTON BEACH
State FL
ZIP 32547
Phone 850 863-3199
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2025
Certificate Expiration Date 2/21/2027
Facility Type Physician Office
Lab Director GUSTAVO F. ROS

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