11D2161220 CLIA NUMBER - IMAGINE PEDIATRICS, PC

Laboratory Demographics

  • CLIA Code: 11D2161220
  • Facility Name: IMAGINE PEDIATRICS, PC
  • Facility Address: 18 RIVERBEND DRIVE, SW, SUITE 210
    ROME, GA
    ZIP 30161
  • Facility Phone: 334 291-8360
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERICA PAEZ-ZAPATA
  • NPI Number: 1477029759
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2161220
LAB Type Physician Office
Facility Name IMAGINE PEDIATRICS, PC
Street 18 RIVERBEND DRIVE, SW, SUITE 210
City ROME
State GA
ZIP 30161
Phone 334 291-8360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/29/2025
Certificate Expiration Date 1/28/2027
Facility Type Physician Office
Lab Director ERICA PAEZ-ZAPATA

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