01D2292600 CLIA NUMBER - LITTLE RIVER PEDIATRICS INC

Laboratory Demographics

  • CLIA Code: 01D2292600
  • Facility Name: LITTLE RIVER PEDIATRICS INC
  • Facility Address: 314 WOODWARD AVE, STE C
    MUSCLE SHOALS, AL
    ZIP 35661
  • Facility Phone: 256 412-4743
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DONNA MONTGOMERY BOGUS
  • NPI Number: 1154107951
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 01D2292600
LAB Type Practitioner Other
Facility Name LITTLE RIVER PEDIATRICS INC
Street 314 WOODWARD AVE, STE C
City MUSCLE SHOALS
State AL
ZIP 35661
Phone 256 412-4743
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2023
Certificate Expiration Date 10/25/2025
Facility Type Practitioner Other
Lab Director DONNA MONTGOMERY BOGUS

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