10D0696839 CLIA NUMBER - ENGLEWOOD PEDIATRICS PA

Laboratory Demographics

  • CLIA Code: 10D0696839
  • Facility Name: ENGLEWOOD PEDIATRICS PA
  • Facility Address: 900 E PINE ST #216-217
    ENGLEWOOD, FL
    ZIP 34223
  • Facility Phone: 941 474-5093
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELLA M. GUASTAVINO MD
  • NPI Number: 1356470744
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D0696839
LAB Type Physician Office
Facility Name ENGLEWOOD PEDIATRICS PA
Street 900 E PINE ST #216-217
City ENGLEWOOD
State FL
ZIP 34223
Phone 941 474-5093
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/17/2024
Certificate Expiration Date 3/16/2026
Facility Type Physician Office
Lab Director ELLA M. GUASTAVINO MD

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