10D2281201 CLIA NUMBER - SANTA ROSA HMA PHYSICIAN MANAGEMENT, LLC

Laboratory Demographics

  • CLIA Code: 10D2281201
  • Facility Name: SANTA ROSA HMA PHYSICIAN MANAGEMENT, LLC
  • Facility Address: 5804 DOGWOOD DRIVE
    MILTON, FL
    ZIP 32570
  • Facility Phone: 850 983-4498
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KAREN HOFFMAN
  • NPI Number: 1013078104
  • Taxonomy: 103TS0200X - Psychologist

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CLIA Record

Field Name Field Value
CLIA Number 10D2281201
LAB Type Physician Office
Facility Name SANTA ROSA HMA PHYSICIAN MANAGEMENT, LLC
Street 5804 DOGWOOD DRIVE
City MILTON
State FL
ZIP 32570
Phone 850 983-4498
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2025
Certificate Expiration Date 5/2/2027
Facility Type Physician Office
Lab Director KAREN HOFFMAN

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