01D0306300 CLIA NUMBER - PEDIATRIC CLINIC

Laboratory Demographics

  • Code: 01D0306300
  • Facility Name: PEDIATRIC CLINIC
  • Facility Address: 2401 VILLAGE PROFESSIONAL DRIVE
    OPELIKA, AL
    ZIP 36801
  • Facility Phone: 334 749-8121
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • NPI Number: 1205977089
  • Taxonomy: 208000000X - Pediatrics
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CLIA Record

Field Name Field Value
CLIA Number 01D0306300
LAB Type Physician Office
Facility Name PEDIATRIC CLINIC
Street 2401 VILLAGE PROFESSIONAL DRIVE
City OPELIKA
State AL
ZIP 36801
Phone 334 749-8121
Certificate Type 2
Certificate Effective Date 9/22/2023
Certificate Expiration Date 9/21/2025
Facility Type Compliance

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This page was last updated on: 4/23/2024