10D2005200 CLIA NUMBER - TAVARES PEDIATRICS

Laboratory Demographics

  • CLIA Code: 10D2005200
  • Facility Name: TAVARES PEDIATRICS
  • Facility Address: 2754 DORA AVE
    TAVARES, FL
    ZIP 32778
  • Facility Phone: 352 508-5176
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: MOHAMMAD AFZAL
  • NPI Number: 1629641923
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2005200
LAB Type Rural Health Clinic
Facility Name TAVARES PEDIATRICS
Street 2754 DORA AVE
City TAVARES
State FL
ZIP 32778
Phone 352 508-5176
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2024
Certificate Expiration Date 3/22/2026
Facility Type Rural Health Clinic
Lab Director MOHAMMAD AFZAL

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