16D2018287 CLIA NUMBER - QUAD CITIES PEDIATRICS, PC

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Laboratory Demographics

CLIA Number: 16D2018287

Facility Name: QUAD CITIES PEDIATRICS, PC

Facility Address:
5510 UTICA RIDGE ROAD, STE 100
DAVENPORT, IA
ZIP 52807
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Facility Phone Number: 563 424-2025

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1174818447

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	16D2018287
LAB Type	Physician Office
Facility Name	QUAD CITIES PEDIATRICS, PC
Street	5510 UTICA RIDGE ROAD, STE 100
City	DAVENPORT
State	IA
ZIP	52807
Phone	563 424-2025
CertificateType	4
CertificateEffectiveDate	12/30/2022
CertificateExpirationDate	12/29/2024
FacilityType	Waiver

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