01D2148957 CLIA NUMBER - KIDS CLINIC

Laboratory Demographics

CLIA Number: 01D2148957

Facility Name: KIDS CLINIC

Facility Address:
119 STEPHEN J WHITE MEMORIAL BLVD
TALLADEGA, AL
ZIP 35160
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Facility Phone Number: 205 268-7775

Facility Type: Rural Health Clinic

Certificate Type: Certificate of Compliance

NPI Number: 1154810224

Taxonomy: 2080A0000X - Pediatrics
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

CLIA Record

Field Name	Field Value
CLIA Number	01D2148957
LAB Type	Rural Health Clinic
Facility Name	KIDS CLINIC
Street	119 STEPHEN J WHITE MEMORIAL BLVD
City	TALLADEGA
State	AL
ZIP	35160
Phone	205 268-7775
CertificateType	2
CertificateEffectiveDate	6/12/2023
CertificateExpirationDate	6/11/2025
FacilityType	Compliance

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