10D2077519 CLIA NUMBER - PEDIATRIC ENDOCRINE ASSOCIATES

Laboratory Demographics

  • CLIA Code: 10D2077519
  • Facility Name: PEDIATRIC ENDOCRINE ASSOCIATES
  • Facility Address: 3001 W MARTIN LUTHER KING JR BLVD
    TAMPA, FL
    ZIP 33607
  • Facility Phone: 813 554-8420
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TERRY J. DECLUE
  • NPI Number: 1316135270
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 10D2077519
LAB Type Physician Office
Facility Name PEDIATRIC ENDOCRINE ASSOCIATES
Street 3001 W MARTIN LUTHER KING JR BLVD
City TAMPA
State FL
ZIP 33607
Phone 813 554-8420
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2024
Certificate Expiration Date 5/8/2026
Facility Type Physician Office
Lab Director TERRY J. DECLUE

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