11D0262347 CLIA NUMBER - PEDS CARE PC

Laboratory Demographics

  • CLIA Code: 11D0262347
  • Facility Name: PEDS CARE PC
  • Facility Address: 1933 SHIELDS ROAD
    DALTON, GA
    ZIP 30720
  • Facility Phone: 706 278-6628
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: RICARDO R. RIESCO
  • NPI Number: 1679730717
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D0262347
LAB Type Physician Office
Facility Name PEDS CARE PC
Street 1933 SHIELDS ROAD
City DALTON
State GA
ZIP 30720
Phone 706 278-6628
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 12/16/2023
Certificate Expiration Date 12/15/2025
Facility Type Physician Office
Lab Director RICARDO R. RIESCO

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