10D2281793 CLIA NUMBER - SPROUT PEDIATRIC CARE, LLC

Laboratory Demographics

  • CLIA Code: 10D2281793
  • Facility Name: SPROUT PEDIATRIC CARE, LLC
  • Facility Address: 4004 NORTON LANE, SUITE 101
    TALLAHASSEE, FL
    ZIP 32308
  • Facility Phone: 850 518-7626
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OLIVER A. REYES
  • NPI Number: 1417901018
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 10D2281793
LAB Type Physician Office
Facility Name SPROUT PEDIATRIC CARE, LLC
Street 4004 NORTON LANE, SUITE 101
City TALLAHASSEE
State FL
ZIP 32308
Phone 850 518-7626
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Physician Office
Lab Director OLIVER A. REYES

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