10D1049528 CLIA NUMBER - PEDIATRIC ASSOCIATES

Laboratory Demographics

  • CLIA Code: 10D1049528
  • Facility Name: PEDIATRIC ASSOCIATES
  • Facility Address: 493 PROSPERITY LAKE DR
    SAINT AUGUSTINE, FL
    ZIP 32092
  • Facility Phone: 954 965-7754
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BARBARA ALEXANDER
  • NPI Number: 1104867670
  • Taxonomy: 235Z00000X - Speech-Language Pathologist

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CLIA Record

Field Name Field Value
CLIA Number 10D1049528
LAB Type Physician Office
Facility Name PEDIATRIC ASSOCIATES
Street 493 PROSPERITY LAKE DR
City SAINT AUGUSTINE
State FL
ZIP 32092
Phone 954 965-7754
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2024
Certificate Expiration Date 1/9/2026
Facility Type Physician Office
Lab Director BARBARA ALEXANDER

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