10D2012851 CLIA NUMBER - DE LA VEGA PEDIATRICS

Laboratory Demographics

  • CLIA Code: 10D2012851
  • Facility Name: DE LA VEGA PEDIATRICS
  • Facility Address: 12781 WORLD PLAZA LANE - STE 1
    FORT MYERS, FL
    ZIP 33907
  • Facility Phone: (239) 277-5877
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ARNALDO DE LA VEGA
  • NPI Number: 1790066983
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 10D2012851
LAB Type Physician Office
Facility Name DE LA VEGA PEDIATRICS
Street 12781 WORLD PLAZA LANE - STE 1
City FORT MYERS
State FL
ZIP 33907
Phone 2392775877
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2024
Certificate Expiration Date 9/8/2026
Facility Type Physician Office
Lab Director ARNALDO DE LA VEGA

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This page was last updated on: 5/18/2026