10D2221356 CLIA NUMBER - BEACHSIDE PEDIATRIC ASSOCIATES PA

Laboratory Demographics

  • CLIA Code: 10D2221356
  • Facility Name: BEACHSIDE PEDIATRIC ASSOCIATES PA
  • Facility Address: 490 HWY 85 N STE A
    NICEVILLE, FL
    ZIP 32578
  • Facility Phone: 850 424-6208
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LALTHA VADLAMANI-SIMMERS
  • NPI Number: 1225634462
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2221356
LAB Type Physician Office
Facility Name BEACHSIDE PEDIATRIC ASSOCIATES PA
Street 490 HWY 85 N STE A
City NICEVILLE
State FL
ZIP 32578
Phone 850 424-6208
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Physician Office
Lab Director LALTHA VADLAMANI-SIMMERS

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