10D0695624 CLIA NUMBER - CHILDREN'S MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 10D0695624
  • Facility Name: CHILDREN'S MEDICAL CENTER
  • Facility Address: 789 W DUVAL ST
    LAKE CITY, FL
    ZIP 32055
  • Facility Phone: (386) 755-1546
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANDRES R. VILLAR
  • NPI Number: 1356435457
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D0695624
LAB Type Physician Office
Facility Name CHILDREN'S MEDICAL CENTER
Street 789 W DUVAL ST
City LAKE CITY
State FL
ZIP 32055
Phone 3867551546
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director ANDRES R. VILLAR

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This page was last updated on: 5/18/2026