11D2119083 CLIA NUMBER - GRAYSON PEDIATRICS, LLC

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Laboratory Demographics

CLIA Number: 11D2119083

Facility Name: GRAYSON PEDIATRICS, LLC

Facility Address:
297 COOPER ROAD
LOGANVILLE, GA
ZIP 30052
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Facility Phone Number: 678 381-2630

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1831500370

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	11D2119083
LAB Type	Physician Office
Facility Name	GRAYSON PEDIATRICS, LLC
Street	297 COOPER ROAD
City	LOGANVILLE
State	GA
ZIP	30052
Phone	678 381-2630
CertificateType	4
CertificateEffectiveDate	9/20/2022
CertificateExpirationDate	9/19/2024
FacilityType	Waiver

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