10D2100310 CLIA NUMBER - LAKEMONT PEDIATRICS

Laboratory Demographics

  • CLIA Code: 10D2100310
  • Facility Name: LAKEMONT PEDIATRICS
  • Facility Address: 157 N LAKEMONT AVE
    WINTER PARK, FL
    ZIP 32792
  • Facility Phone: 407 644-6618
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIVIEN PHAM
  • NPI Number: 1053793190
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D2100310
LAB Type Physician Office
Facility Name LAKEMONT PEDIATRICS
Street 157 N LAKEMONT AVE
City WINTER PARK
State FL
ZIP 32792
Phone 407 644-6618
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/12/2025
Certificate Expiration Date 8/11/2027
Facility Type Physician Office
Lab Director VIVIEN PHAM

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