11D0256732 CLIA NUMBER - DR MINIYARS PEDICATRICS PC

Laboratory Demographics

  • CLIA Code: 11D0256732
  • Facility Name: DR MINIYARS PEDICATRICS PC
  • Facility Address: 140 THREE RIVERS DRIVE
    ROME, GA
    ZIP 30161
  • Facility Phone: 706 232-1300
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAJ MINIYAR
  • NPI Number: 1760651806
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D0256732
LAB Type Physician Office
Facility Name DR MINIYARS PEDICATRICS PC
Street 140 THREE RIVERS DRIVE
City ROME
State GA
ZIP 30161
Phone 706 232-1300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2024
Certificate Expiration Date 2/20/2026
Facility Type Physician Office
Lab Director RAJ MINIYAR

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