05D0572174 CLIA NUMBER - ADOLESCENTS, BABIES & CHILDREN PEDIATRIC MED GROUP

Laboratory Demographics

  • CLIA Code: 05D0572174
  • Facility Name: ADOLESCENTS, BABIES & CHILDREN PEDIATRIC MED GROUP
  • Facility Address: 702 WAKE AVENUE AVE
    EL CENTRO, CA
    ZIP 92243
  • Facility Phone: 760 352-7216
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALFREDO NEGRETE, MD
  • NPI Number: 1497275291
  • Taxonomy: 261QM0801X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 05D0572174
LAB Type Physician Office
Facility Name ADOLESCENTS, BABIES & CHILDREN PEDIATRIC MED GROUP
Street 702 WAKE AVENUE AVE
City EL CENTRO
State CA
ZIP 92243
Phone 760 352-7216
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director ALFREDO NEGRETE, MD

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This page was last updated on: 3/20/2025