10D1046452 CLIA NUMBER - PEDIATRIC SPECIALISTS

Laboratory Demographics

  • CLIA Code: 10D1046452
  • Facility Name: PEDIATRIC SPECIALISTS
  • Facility Address: 15901 BASS RD, STE 102
    FORT MYERS, FL
    ZIP 33908
  • Facility Phone: 239 343-9905
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASJAD KHAN
  • NPI Number: 1871864215
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D1046452
LAB Type Physician Office
Facility Name PEDIATRIC SPECIALISTS
Street 15901 BASS RD, STE 102
City FORT MYERS
State FL
ZIP 33908
Phone 239 343-9905
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2025
Certificate Expiration Date 10/9/2027
Facility Type Physician Office
Lab Director ASJAD KHAN

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