10D1060446 CLIA NUMBER - ANASTASIA PEDIATRICS

Laboratory Demographics

  • CLIA Code: 10D1060446
  • Facility Name: ANASTASIA PEDIATRICS
  • Facility Address: 101 WHITEHALL DR STE 103
    SAINT AUGUSTINE, FL
    ZIP 32086
  • Facility Phone: 904 819-9925
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MONALI MANIKAL
  • NPI Number: 1205192739
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D1060446
LAB Type Physician Office
Facility Name ANASTASIA PEDIATRICS
Street 101 WHITEHALL DR STE 103
City SAINT AUGUSTINE
State FL
ZIP 32086
Phone 904 819-9925
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2024
Certificate Expiration Date 10/23/2026
Facility Type Physician Office
Lab Director MONALI MANIKAL

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