10D2014597 CLIA NUMBER - MAGNOLIA PEDIATRICS GROUP LLC

Laboratory Demographics

  • CLIA Code: 10D2014597
  • Facility Name: MAGNOLIA PEDIATRICS GROUP LLC
  • Facility Address: 2406 E PLAZA DR
    TALLAHASSEE, FL
    ZIP 32308
  • Facility Phone: 850 878-5322
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TODD PATTERSON
  • NPI Number: 1831535442
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 10D2014597
LAB Type Physician Office
Facility Name MAGNOLIA PEDIATRICS GROUP LLC
Street 2406 E PLAZA DR
City TALLAHASSEE
State FL
ZIP 32308
Phone 850 878-5322
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2024
Certificate Expiration Date 10/12/2026
Facility Type Physician Office
Lab Director TODD PATTERSON

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