10D0270243 CLIA NUMBER - PROFESSIONAL PARK PEDIATRICS PA

Laboratory Demographics

  • CLIA Code: 10D0270243
  • Facility Name: PROFESSIONAL PARK PEDIATRICS PA
  • Facility Address: 1881 PROFESSIONAL PARK CIR STE 80
    TALLAHASSEE, FL
    ZIP 32308
  • Facility Phone: 850 402-5454
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: WALTER G. BUNNELL
  • NPI Number: 1841289204
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D0270243
LAB Type Physician Office
Facility Name PROFESSIONAL PARK PEDIATRICS PA
Street 1881 PROFESSIONAL PARK CIR STE 80
City TALLAHASSEE
State FL
ZIP 32308
Phone 850 402-5454
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Physician Office
Lab Director WALTER G. BUNNELL

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