11D1012974 CLIA NUMBER - EATONTON PEDICATRICS

Laboratory Demographics

  • CLIA Code: 11D1012974
  • Facility Name: EATONTON PEDICATRICS
  • Facility Address: 116 SPARTA HIGHWAY
    EATONTON, GA
    ZIP 31024
  • Facility Phone: 706 923-0704
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MUNEER AL HAKIM
  • NPI Number: 1902064918
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D1012974
LAB Type Physician Office
Facility Name EATONTON PEDICATRICS
Street 116 SPARTA HIGHWAY
City EATONTON
State GA
ZIP 31024
Phone 706 923-0704
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/27/2025
Certificate Expiration Date 5/26/2027
Facility Type Physician Office
Lab Director MUNEER AL HAKIM

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