11D0918374 CLIA NUMBER - DEKALB PEDIATRIC CENTER PC

Laboratory Demographics

CLIA Number: 11D0918374

Facility Name: DEKALB PEDIATRIC CENTER PC

Facility Address:
350 WINN WAY
DECATUR, GA
ZIP 30030
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Facility Phone Number: 404 508-1177

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1164695458

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name	Field Value
CLIA Number	11D0918374
LAB Type	Physician Office
Facility Name	DEKALB PEDIATRIC CENTER PC
Street	350 WINN WAY
City	DECATUR
State	GA
ZIP	30030
Phone	404 508-1177
CertificateType	4
CertificateEffectiveDate	8/7/2022
CertificateExpirationDate	8/6/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024