01D0300405 CLIA NUMBER - SYLACAUGA PEDIATRIC CLINIC LLC

Laboratory Demographics

CLIA Number: 01D0300405

Facility Name: SYLACAUGA PEDIATRIC CLINIC LLC

Facility Address:
115 WEST CLAY STREET
SYLACAUGA, AL
ZIP 35150
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Facility Phone Number: (256) 245-3267

Facility Type: PHYSICIAN OFFICE

Certificate Type: Certificate of Compliance

NPI Number: 1912948373

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	01D0300405
LAB Type	PHYSICIAN OFFICE
Facility Name	SYLACAUGA PEDIATRIC CLINIC LLC
Street	115 WEST CLAY STREET
City	SYLACAUGA
State	AL
ZIP	35150
Phone	(256) 245-3267

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This page was last updated on: 5/11/2023