10D2008449 CLIA NUMBER - FORT MYERS PEDIATRICS LLC

Laboratory Demographics

  • CLIA Code: 10D2008449
  • Facility Name: FORT MYERS PEDIATRICS LLC
  • Facility Address: 13770 PLANTATION RD SUITE 1
    FORT MYERS, FL
    ZIP 33912
  • Facility Phone: 239 689-5561
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ROLONDO OTERO
  • NPI Number: 1972823409
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D2008449
LAB Type Physician Office
Facility Name FORT MYERS PEDIATRICS LLC
Street 13770 PLANTATION RD SUITE 1
City FORT MYERS
State FL
ZIP 33912
Phone 239 689-5561
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2024
Certificate Expiration Date 6/9/2026
Facility Type Physician Office
Lab Director DR. ROLONDO OTERO

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