10D1078845 CLIA NUMBER - PEDIATRICA OF COCONUT CREEK

Laboratory Demographics

  • CLIA Code: 10D1078845
  • Facility Name: PEDIATRICA OF COCONUT CREEK
  • Facility Address: 4400 W SAMPLE RD STE 122
    COCONUT CREEK, FL
    ZIP 33073
  • Facility Phone: 954 978-6130
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ARIF WAJID
  • NPI Number: 1649441981
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 10D1078845
LAB Type Physician Office
Facility Name PEDIATRICA OF COCONUT CREEK
Street 4400 W SAMPLE RD STE 122
City COCONUT CREEK
State FL
ZIP 33073
Phone 954 978-6130
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2023
Certificate Expiration Date 11/11/2025
Facility Type Physician Office
Lab Director ARIF WAJID

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