10D2301996 CLIA NUMBER - PENN PEDIATRICS LLC

Laboratory Demographics

  • CLIA Code: 10D2301996
  • Facility Name: PENN PEDIATRICS LLC
  • Facility Address: 260 SW NATURA AVE, STE 102
    DEERFIELD BEACH, FL
    ZIP 33441
  • Facility Phone: 954 505-8524
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SABINA THATCHER
  • NPI Number: 1568239861
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D2301996
LAB Type Physician Office
Facility Name PENN PEDIATRICS LLC
Street 260 SW NATURA AVE, STE 102
City DEERFIELD BEACH
State FL
ZIP 33441
Phone 954 505-8524
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2024
Certificate Expiration Date 4/2/2026
Facility Type Physician Office
Lab Director SABINA THATCHER

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