11D1104859 CLIA NUMBER - PRESTIGE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D1104859
  • Facility Name: PRESTIGE PEDIATRICS
  • Facility Address: 600 POINTE NORTH BLVD
    ALBANY, GA
    ZIP 31721
  • Facility Phone: 229 883-7867
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TANIA SMITH MD
  • NPI Number: 1578794640
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D1104859
LAB Type Physician Office
Facility Name PRESTIGE PEDIATRICS
Street 600 POINTE NORTH BLVD
City ALBANY
State GA
ZIP 31721
Phone 229 883-7867
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/11/2025
Certificate Expiration Date 9/10/2027
Facility Type Physician Office
Lab Director TANIA SMITH MD

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