10D1098965 CLIA NUMBER - PM PEDIATRICS

Laboratory Demographics

  • CLIA Code: 10D1098965
  • Facility Name: PM PEDIATRICS
  • Facility Address: 1412 W VINE ST
    KISSIMMEE, FL
    ZIP 34741
  • Facility Phone: 407 483-0672
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. AZIZ IMTIAZ
  • NPI Number: 1508071374
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D1098965
LAB Type Physician Office
Facility Name PM PEDIATRICS
Street 1412 W VINE ST
City KISSIMMEE
State FL
ZIP 34741
Phone 407 483-0672
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2024
Certificate Expiration Date 8/17/2026
Facility Type Physician Office
Lab Director DR. AZIZ IMTIAZ

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