10D0271843 CLIA NUMBER - BENTON PEDIATRICS, INC

Laboratory Demographics

CLIA Code: 10D0271843
Facility Name: BENTON PEDIATRICS, INC
Facility Address: 5612 NW 43RD ST
GAINESVILLE, FL
ZIP 32653
Facility Phone: 352 376-4542
Facility Type: Physician Office
Facility Type: Waiver
Lab Director: CHARLES POWERS
NPI Number: 1093956526
Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness

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CLIA Record

Field Name	Field Value
CLIA Number	10D0271843
LAB Type	Physician Office
Facility Name	BENTON PEDIATRICS, INC
Street	5612 NW 43RD ST
City	GAINESVILLE
State	FL
ZIP	32653
Phone	352 376-4542
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	1/11/2025
Certificate Expiration Date	1/10/2027
Facility Type	Physician Office
Lab Director	CHARLES POWERS

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