10D0902416 CLIA NUMBER - PEDIATRIC HEALTHCARE ALLIANCE PA

Laboratory Demographics

  • CLIA Code: 10D0902416
  • Facility Name: PEDIATRIC HEALTHCARE ALLIANCE PA
  • Facility Address: 5259 VILLAGE MARKET
    WESLEY CHAPEL, FL
    ZIP 33544
  • Facility Phone: 813 973-2003
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACQUELINE V. HARTMAN MD
  • NPI Number: 1407522352
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D0902416
LAB Type Physician Office
Facility Name PEDIATRIC HEALTHCARE ALLIANCE PA
Street 5259 VILLAGE MARKET
City WESLEY CHAPEL
State FL
ZIP 33544
Phone 813 973-2003
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2024
Certificate Expiration Date 9/16/2026
Facility Type Physician Office
Lab Director JACQUELINE V. HARTMAN MD

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