10D1075329 CLIA NUMBER - BEACHES PEDIATRICS PA

Laboratory Demographics

  • CLIA Code: 10D1075329
  • Facility Name: BEACHES PEDIATRICS PA
  • Facility Address: 13820 OLD ST AUGUSTINE RD STE 101
    JACKSONVILLE, FL
    ZIP 32258
  • Facility Phone: 904 246-8684
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JORGE RIVERA
  • NPI Number: 1295989606
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D1075329
LAB Type Practitioner Other
Facility Name BEACHES PEDIATRICS PA
Street 13820 OLD ST AUGUSTINE RD STE 101
City JACKSONVILLE
State FL
ZIP 32258
Phone 904 246-8684
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2025
Certificate Expiration Date 10/17/2027
Facility Type Practitioner Other
Lab Director JORGE RIVERA

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