10D2295030 CLIA NUMBER - PANHANDLE THERAPY CENTER LLC

Laboratory Demographics

  • CLIA Code: 10D2295030
  • Facility Name: PANHANDLE THERAPY CENTER LLC
  • Facility Address: 20311 CENTRAL AVE WEST
    BLOUNTSTOWN, FL
    ZIP 32424
  • Facility Phone: 850 674-8888
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: HEALTHER KING
  • NPI Number: 1457981888
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2295030
LAB Type Practitioner Other
Facility Name PANHANDLE THERAPY CENTER LLC
Street 20311 CENTRAL AVE WEST
City BLOUNTSTOWN
State FL
ZIP 32424
Phone 850 674-8888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/5/2023
Certificate Expiration Date 12/4/2025
Facility Type Practitioner Other
Lab Director HEALTHER KING

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