05D2219224 CLIA NUMBER - PEDIATRIC ALTERNATIVES

Laboratory Demographics

  • CLIA Code: 05D2219224
  • Facility Name: PEDIATRIC ALTERNATIVES
  • Facility Address: 10 THOMAS DRIVE
    MILL VALLEY, CA
    ZIP 94941
  • Facility Phone: 415 380-8448
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STACIA KENET
  • NPI Number: 1669732772
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 05D2219224
LAB Type Physician Office
Facility Name PEDIATRIC ALTERNATIVES
Street 10 THOMAS DRIVE
City MILL VALLEY
State CA
ZIP 94941
Phone 415 380-8448
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2025
Certificate Expiration Date 4/1/2027
Facility Type Physician Office
Lab Director STACIA KENET

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