16D2293516 CLIA NUMBER - GROWING WITH YOU PEDIATRICS

Laboratory Demographics

CLIA Number: 16D2293516

Facility Name: GROWING WITH YOU PEDIATRICS

Facility Address:
1075 GOLDEN VALLEY DR
BETTENDORF, IA
ZIP 52722
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Facility Phone Number: 563 900-5996

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1770365843

Taxonomy: 363LP0200X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	16D2293516
LAB Type	Practitioner Other
Facility Name	GROWING WITH YOU PEDIATRICS
Street	1075 GOLDEN VALLEY DR
City	BETTENDORF
State	IA
ZIP	52722
Phone	563 900-5996
CertificateType	4
CertificateEffectiveDate	11/9/2023
CertificateExpirationDate	11/8/2025
FacilityType	Waiver

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