11D2053163 CLIA NUMBER - UNIVERSITY PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D2053163
  • Facility Name: UNIVERSITY PEDIATRICS
  • Facility Address: 4790 WATERS AVENUE, SUITE 100
    SAVANNAH, GA
    ZIP 31404
  • Facility Phone: 912 350-8180
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. JESSICA DONALDSON
  • NPI Number: 1609170901
  • Taxonomy: 2080P0207X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2053163
LAB Type Physician Office
Facility Name UNIVERSITY PEDIATRICS
Street 4790 WATERS AVENUE, SUITE 100
City SAVANNAH
State GA
ZIP 31404
Phone 912 350-8180
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2025
Certificate Expiration Date 1/27/2027
Facility Type Physician Office
Lab Director DR. JESSICA DONALDSON

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