10D1028746 CLIA NUMBER - ANGEL KIDS PA

Laboratory Demographics

  • CLIA Code: 10D1028746
  • Facility Name: ANGEL KIDS PA
  • Facility Address: 13443 ATLANTIC BLVD
    JACKSONVILLE, FL
    ZIP 32225
  • Facility Phone: 904 224-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASHRAF A. AFFAN
  • NPI Number: 1174199137
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D1028746
LAB Type Physician Office
Facility Name ANGEL KIDS PA
Street 13443 ATLANTIC BLVD
City JACKSONVILLE
State FL
ZIP 32225
Phone 904 224-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2023
Certificate Expiration Date 11/3/2025
Facility Type Physician Office
Lab Director ASHRAF A. AFFAN

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