10D2161723 CLIA NUMBER - ANGEL KIDS PA

Laboratory Demographics

  • CLIA Code: 10D2161723
  • Facility Name: ANGEL KIDS PA
  • Facility Address: 2040 RIVERVIEW ST
    JACKSONVILLE, FL
    ZIP 32208
  • Facility Phone: 904 224-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASHRAF A. AFFAN
  • NPI Number: 1598331563
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D2161723
LAB Type Physician Office
Facility Name ANGEL KIDS PA
Street 2040 RIVERVIEW ST
City JACKSONVILLE
State FL
ZIP 32208
Phone 904 224-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2025
Certificate Expiration Date 2/7/2027
Facility Type Physician Office
Lab Director ASHRAF A. AFFAN

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