11D1091809 CLIA NUMBER - NUESTROS NINOS OUR KIDS PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D1091809
  • Facility Name: NUESTROS NINOS OUR KIDS PEDIATRICS
  • Facility Address: 777 FRANKLIN GATEWAY SE
    MARIETTA, GA
    ZIP 30067
  • Facility Phone: 770 732-6007
  • Facility Type: Practitioner Other
  • Facility Type: Certificate of Compliance
  • Lab Director: EDUARDO E. MONTANA
  • NPI Number: 1932648730
  • Taxonomy: 363LP0200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 11D1091809
LAB Type Practitioner Other
Facility Name NUESTROS NINOS OUR KIDS PEDIATRICS
Street 777 FRANKLIN GATEWAY SE
City MARIETTA
State GA
ZIP 30067
Phone 770 732-6007
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 3/11/2023
Certificate Expiration Date 10/31/2025
Facility Type Practitioner Other
Lab Director EDUARDO E. MONTANA

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