10D1043678 CLIA NUMBER - PRIMARY CARE PEDIATRICS PA

Laboratory Demographics

  • CLIA Code: 10D1043678
  • Facility Name: PRIMARY CARE PEDIATRICS PA
  • Facility Address: 1507 S HIAWASSEE RD #105
    ORLANDO, FL
    ZIP 32835
  • Facility Phone: 407 445-9224
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: REVATI D. NARAHARI
  • NPI Number: 1760587349
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D1043678
LAB Type Physician Office
Facility Name PRIMARY CARE PEDIATRICS PA
Street 1507 S HIAWASSEE RD #105
City ORLANDO
State FL
ZIP 32835
Phone 407 445-9224
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2025
Certificate Expiration Date 7/31/2027
Facility Type Physician Office
Lab Director REVATI D. NARAHARI

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