10D2313113 CLIA NUMBER - PEDIATRICS IN BREVARD

Laboratory Demographics

  • CLIA Code: 10D2313113
  • Facility Name: PEDIATRICS IN BREVARD
  • Facility Address: 1220 N HIGHWAY A1A STE 147
    INDIALANTIC, FL
    ZIP 32903
  • Facility Phone: 321 951-9087
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHN C. KENNEDY
  • NPI Number: 1629069240
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D2313113
LAB Type Physician Office
Facility Name PEDIATRICS IN BREVARD
Street 1220 N HIGHWAY A1A STE 147
City INDIALANTIC
State FL
ZIP 32903
Phone 321 951-9087
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/24/2024
Certificate Expiration Date 10/23/2026
Facility Type Physician Office
Lab Director JOHN C. KENNEDY

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