10D2257076 CLIA NUMBER - PBJ MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 10D2257076
  • Facility Name: PBJ MEDICAL ASSOCIATES
  • Facility Address: 628 MAITLAND BLVD
    ALTAMONTE SPRINGS, FL
    ZIP 32701
  • Facility Phone: (321) 522-7708
  • Facility Type: Other - COMMUNITY TESTER / MULT
  • Facility Type: Waiver
  • Lab Director: KEVIN PRUITT
  • NPI Number: 1033900451
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 10D2257076
LAB Type Other - COMMUNITY TESTER / MULT
Facility Name PBJ MEDICAL ASSOCIATES
Street 628 MAITLAND BLVD
City ALTAMONTE SPRINGS
State FL
ZIP 32701
Phone 3215227708
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2026
Certificate Expiration Date 3/30/2028
Facility Type Other - COMMUNITY TESTER / MULT
Lab Director KEVIN PRUITT

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This page was last updated on: 5/18/2026