10D2293541 CLIA NUMBER - WOODLANDS MEDICAL SPECIALISTS

Laboratory Demographics

CLIA Number: 10D2293541

Facility Name: WOODLANDS MEDICAL SPECIALISTS

Facility Address:
601 W REDSTONE AVE SUITE 200
CRESTVIEW, FL
ZIP 32536
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Facility Phone Number: 850 696-4000

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1225274772

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	10D2293541
LAB Type	Physician Office
Facility Name	WOODLANDS MEDICAL SPECIALISTS
Street	601 W REDSTONE AVE SUITE 200
City	CRESTVIEW
State	FL
ZIP	32536
Phone	850 696-4000
CertificateType	4
CertificateEffectiveDate	11/9/2023
CertificateExpirationDate	11/8/2025
FacilityType	Waiver

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