01D2117879 CLIA NUMBER - EASTERN SHORE CHILDREN'S CLINIC

Laboratory Demographics

CLIA Code: 01D2117879
Facility Name: EASTERN SHORE CHILDREN'S CLINIC
Facility Address: 9603 STAGECOACH COMMERCIAL PARK CIRCLE
SPANISH FORT, AL
ZIP 36527
Facility Phone: 251 928-0624
Facility Type: Physician Office
Facility Type: Certificate of Compliance
Lab Director: DR. SUSIE FITZHARRIS
NPI Number: 1447614854
Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name	Field Value
CLIA Number	01D2117879
LAB Type	Physician Office
Facility Name	EASTERN SHORE CHILDREN'S CLINIC
Street	9603 STAGECOACH COMMERCIAL PARK CIRCLE
City	SPANISH FORT
State	AL
ZIP	36527
Phone	251 928-0624
Certificate Type	Certificate of Compliance
Certificate Type Description	This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date	11/29/2024
Certificate Expiration Date	11/28/2026
Facility Type	Physician Office
Lab Director	DR. SUSIE FITZHARRIS

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