10D0877459 CLIA NUMBER - WEST DADE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 10D0877459
  • Facility Name: WEST DADE PEDIATRICS
  • Facility Address: 3220 SW 107 AVE
    MIAMI, FL
    ZIP 33165
  • Facility Phone: 305 551-1195
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JULIO C. EGUSQUIZA MD
  • NPI Number: 1821392077
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D0877459
LAB Type Physician Office
Facility Name WEST DADE PEDIATRICS
Street 3220 SW 107 AVE
City MIAMI
State FL
ZIP 33165
Phone 305 551-1195
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/18/2025
Certificate Expiration Date 4/17/2027
Facility Type Physician Office
Lab Director JULIO C. EGUSQUIZA MD

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