10D2024451 CLIA NUMBER - PROFESSIONAL PEDIATRICS

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Laboratory Demographics

CLIA Number: 10D2024451

Facility Name: PROFESSIONAL PEDIATRICS

Facility Address:
1050 US HWY 27 STE 5
CLERMONT, FL
ZIP 34714
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Facility Phone Number: 352 404-8944

Facility Type: Rural Health Clinic

Certificate Type: Waiver

NPI Number: 1992378202

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	10D2024451
LAB Type	Rural Health Clinic
Facility Name	PROFESSIONAL PEDIATRICS
Street	1050 US HWY 27 STE 5
City	CLERMONT
State	FL
ZIP	34714
Phone	352 404-8944
CertificateType	4
CertificateEffectiveDate	7/26/2023
CertificateExpirationDate	7/25/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024