10D2107413 CLIA NUMBER - NICHOLS PEDIATRIC CENTER

Laboratory Demographics

  • CLIA Code: 10D2107413
  • Facility Name: NICHOLS PEDIATRIC CENTER
  • Facility Address: 5450 YMCA RD STE 102
    NAPLES, FL
    ZIP 34109
  • Facility Phone: 239 658-3131
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: SALVATORE ANZALONE
  • NPI Number: 1689031049
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2107413
LAB Type Federally Qualified Health Center
Facility Name NICHOLS PEDIATRIC CENTER
Street 5450 YMCA RD STE 102
City NAPLES
State FL
ZIP 34109
Phone 239 658-3131
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/13/2024
Certificate Expiration Date 1/12/2026
Facility Type Federally Qualified Health Center
Lab Director SALVATORE ANZALONE

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