10D2024540 CLIA NUMBER - PEDIATRIC PHYSICIAN SERVICES INC

Laboratory Demographics

  • CLIA Code: 10D2024540
  • Facility Name: PEDIATRIC PHYSICIAN SERVICES INC
  • Facility Address: 601 5TH ST S STE 304 ATTN SUSAN BYRD
    SAINT PETERSBURG, FL
    ZIP 33701
  • Facility Phone: 727 767-3636
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUPAMIT UKARAPONG
  • NPI Number: 1033194816
  • Taxonomy: 2086S0120X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 10D2024540
LAB Type Physician Office
Facility Name PEDIATRIC PHYSICIAN SERVICES INC
Street 601 5TH ST S STE 304 ATTN SUSAN BYRD
City SAINT PETERSBURG
State FL
ZIP 33701
Phone 727 767-3636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Physician Office
Lab Director SUPAMIT UKARAPONG

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