10D2304102 CLIA NUMBER - FONSECA PEDIATRICS LLC

Laboratory Demographics

  • CLIA Code: 10D2304102
  • Facility Name: FONSECA PEDIATRICS LLC
  • Facility Address: 2801 17TH STREET UNIT 102
    SAINT CLOUD, FL
    ZIP 34769
  • Facility Phone: 407 519-2930
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAMON A. FONSECA
  • NPI Number: 1881475762
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D2304102
LAB Type Physician Office
Facility Name FONSECA PEDIATRICS LLC
Street 2801 17TH STREET UNIT 102
City SAINT CLOUD
State FL
ZIP 34769
Phone 407 519-2930
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2024
Certificate Expiration Date 5/6/2026
Facility Type Physician Office
Lab Director RAMON A. FONSECA

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