10D0913334 CLIA NUMBER - LAKE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 10D0913334
  • Facility Name: LAKE PEDIATRICS
  • Facility Address: 4880 N HWY 19A
    MOUNT DORA, FL
    ZIP 32757
  • Facility Phone: 352 383-8111
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: E THOMAS CARLSON
  • NPI Number: 1518631811
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D0913334
LAB Type Physician Office
Facility Name LAKE PEDIATRICS
Street 4880 N HWY 19A
City MOUNT DORA
State FL
ZIP 32757
Phone 352 383-8111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Physician Office
Lab Director E THOMAS CARLSON

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