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10D0955541 CLIA NUMBER - MACKOUL PEDIATRICS

Laboratory Demographics

CLIA Number: 10D0955541

Facility Name: MACKOUL PEDIATRICS

Facility Address:
206 SE 16TH PLACE
CAPE CORAL, FL
ZIP 33990
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Facility Phone Number: 941 573-2001

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1659389948

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name Field Value
CLIA Number 10D0955541
LAB Type Physician Office
Facility Name MACKOUL PEDIATRICS
Street 206 SE 16TH PLACE
City CAPE CORAL
State FL
ZIP 33990
Phone 941 573-2001
CertificateType 4
CertificateEffectiveDate 1/4/2023
CertificateExpirationDate 1/3/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024