05D2024718 CLIA NUMBER - PEDIATRIC WELLNESS GROUP

Laboratory Demographics

  • CLIA Code: 05D2024718
  • Facility Name: PEDIATRIC WELLNESS GROUP
  • Facility Address: 801 BREWSTER AVE, SUITE 175
    REDWOOD CITY, CA
    ZIP 94063
  • Facility Phone: 650 216-7794
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMITA SAXENA
  • NPI Number: 1679871057
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D2024718
LAB Type Physician Office
Facility Name PEDIATRIC WELLNESS GROUP
Street 801 BREWSTER AVE, SUITE 175
City REDWOOD CITY
State CA
ZIP 94063
Phone 650 216-7794
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/23/2025
Certificate Expiration Date 5/22/2027
Facility Type Physician Office
Lab Director AMITA SAXENA

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