14D0430761 CLIA NUMBER - PEDIATRIC GROUP ASSOC

Laboratory Demographics

  • CLIA Code: 14D0430761
  • Facility Name: PEDIATRIC GROUP ASSOC
  • Facility Address: 1625 AVENUE OF THE CITIES
    MOLINE, IL
    ZIP 61265
  • Facility Phone: 309 797-5437
  • Facility Type: Practitioner Other
  • Facility Type: Accreditation
  • Lab Director: HAILE NEPTUNE
  • NPI Number: 1114987252
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 14D0430761
LAB Type Practitioner Other
Facility Name PEDIATRIC GROUP ASSOC
Street 1625 AVENUE OF THE CITIES
City MOLINE
State IL
ZIP 61265
Phone 309 797-5437
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 12/23/2023
Certificate Expiration Date 12/22/2025
Facility Type Practitioner Other
Lab Director HAILE NEPTUNE

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