10D2029096 CLIA NUMBER - BIGBEND PEDIATRIC CARE LLC

Laboratory Demographics

  • CLIA Code: 10D2029096
  • Facility Name: BIGBEND PEDIATRIC CARE LLC
  • Facility Address: 13131 KING LAKE DR STE 101
    GIBSONTON, FL
    ZIP 33534
  • Facility Phone: 813 952-3918
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROLANDO GARCIA
  • NPI Number: 1578908968
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D2029096
LAB Type Physician Office
Facility Name BIGBEND PEDIATRIC CARE LLC
Street 13131 KING LAKE DR STE 101
City GIBSONTON
State FL
ZIP 33534
Phone 813 952-3918
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2025
Certificate Expiration Date 8/30/2027
Facility Type Physician Office
Lab Director ROLANDO GARCIA

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