10D2186725 CLIA NUMBER - PERSONALIZED PEDIATRICS LLC

Laboratory Demographics

  • CLIA Code: 10D2186725
  • Facility Name: PERSONALIZED PEDIATRICS LLC
  • Facility Address: 12621 NW 8TH COURT
    CORAL SPRINGS, FL
    ZIP 33071
  • Facility Phone: 954 543-1760
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EDNA L. TELLO
  • NPI Number: 1215329313
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D2186725
LAB Type Physician Office
Facility Name PERSONALIZED PEDIATRICS LLC
Street 12621 NW 8TH COURT
City CORAL SPRINGS
State FL
ZIP 33071
Phone 954 543-1760
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2024
Certificate Expiration Date 6/21/2026
Facility Type Physician Office
Lab Director EDNA L. TELLO

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