10D2019534 CLIA NUMBER - PEDIATRICA OF PALM COAST

Laboratory Demographics

  • CLIA Code: 10D2019534
  • Facility Name: PEDIATRICA OF PALM COAST
  • Facility Address: 180 PINNACLES DR STE100
    PALM COAST, FL
    ZIP 32164
  • Facility Phone: 386 313-1963
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VINCENT G. VERDEFLOR
  • NPI Number: 1194033753
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D2019534
LAB Type Physician Office
Facility Name PEDIATRICA OF PALM COAST
Street 180 PINNACLES DR STE100
City PALM COAST
State FL
ZIP 32164
Phone 386 313-1963
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2025
Certificate Expiration Date 1/31/2027
Facility Type Physician Office
Lab Director VINCENT G. VERDEFLOR

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