11D2168149 CLIA NUMBER - COASTAL PEDIATRICS

Laboratory Demographics

  • CLIA Code: 11D2168149
  • Facility Name: COASTAL PEDIATRICS
  • Facility Address: 1000 TOWN CENTER BOULEVARD, BUILDING 1000 B
    POOLER, GA
    ZIP 31322
  • Facility Phone: (912) 353-7744
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DUDLEY STONE
  • NPI Number: 1922327055
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 11D2168149
LAB Type Physician Office
Facility Name COASTAL PEDIATRICS
Street 1000 TOWN CENTER BOULEVARD, BUILDING 1000 B
City POOLER
State GA
ZIP 31322
Phone 9123537744
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 11/27/2025
Certificate Expiration Date 11/26/2027
Facility Type Physician Office
Lab Director DUDLEY STONE

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This page was last updated on: 5/18/2026