10D2243557 CLIA NUMBER - PEDIATRIC UNIVERSE LLC

Laboratory Demographics

  • CLIA Code: 10D2243557
  • Facility Name: PEDIATRIC UNIVERSE LLC
  • Facility Address: 3103 INNOVATION DR
    SAINT CLOUD, FL
    ZIP 34769
  • Facility Phone: 860 992-6794
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAMIR DRAA
  • NPI Number: 1275109993
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D2243557
LAB Type Physician Office
Facility Name PEDIATRIC UNIVERSE LLC
Street 3103 INNOVATION DR
City SAINT CLOUD
State FL
ZIP 34769
Phone 860 992-6794
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2023
Certificate Expiration Date 11/18/2025
Facility Type Physician Office
Lab Director SAMIR DRAA

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