10D2044162 CLIA NUMBER - KIDS PLACE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 10D2044162
  • Facility Name: KIDS PLACE PEDIATRICS
  • Facility Address: 466 SW PORT SAINT LUCIE BLVD #116
    PORT SAINT LUCIE, FL
    ZIP 34953
  • Facility Phone: (772) 237-4518
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROSARIO CORREA
  • NPI Number: 1336496629
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D2044162
LAB Type Physician Office
Facility Name KIDS PLACE PEDIATRICS
Street 466 SW PORT SAINT LUCIE BLVD #116
City PORT SAINT LUCIE
State FL
ZIP 34953
Phone 7722374518
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/18/2024
Certificate Expiration Date 7/17/2026
Facility Type Physician Office
Lab Director ROSARIO CORREA

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