10D0977465 CLIA NUMBER - LAKE WORTH PEDIATRICS

Laboratory Demographics

  • CLIA Code: 10D0977465
  • Facility Name: LAKE WORTH PEDIATRICS
  • Facility Address: 3112 SOUTH CONGRESS AVE STE A
    PALM SPRINGS, FL
    ZIP 33461
  • Facility Phone: 561 964-0110
  • Facility Type: Other
  • Facility Type: Waiver
  • Lab Director: NAGARAKERE SHANKARAIAH MD
  • NPI Number: 1588636450
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D0977465
LAB Type Other
Facility Name LAKE WORTH PEDIATRICS
Street 3112 SOUTH CONGRESS AVE STE A
City PALM SPRINGS
State FL
ZIP 33461
Phone 561 964-0110
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2024
Certificate Expiration Date 8/27/2026
Facility Type Other
Lab Director NAGARAKERE SHANKARAIAH MD

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