10D1055842 CLIA NUMBER - INGRAM PEDIATRICS

Laboratory Demographics

  • CLIA Code: 10D1055842
  • Facility Name: INGRAM PEDIATRICS
  • Facility Address: 4100 S HOSPITAL DR STE 302
    PLANTATION, FL
    ZIP 33317
  • Facility Phone: 813 784-8247
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DEBORAH E. INGRAM
  • NPI Number: 1265581383
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D1055842
LAB Type Physician Office
Facility Name INGRAM PEDIATRICS
Street 4100 S HOSPITAL DR STE 302
City PLANTATION
State FL
ZIP 33317
Phone 813 784-8247
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2024
Certificate Expiration Date 6/27/2026
Facility Type Physician Office
Lab Director DEBORAH E. INGRAM

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