19D0463623 CLIA NUMBER - MID CITY PEDIATRIC CLINIC

Laboratory Demographics

  • CLIA Code: 19D0463623
  • Facility Name: MID CITY PEDIATRIC CLINIC
  • Facility Address: 2225 LINE AVENUE
    SHREVEPORT, LA
    ZIP 71104
  • Facility Phone: (318) 221-2225
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: SCOTT RITCH
  • NPI Number: 1902811888
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 19D0463623
LAB Type Physician Office
Facility Name MID CITY PEDIATRIC CLINIC
Street 2225 LINE AVENUE
City SHREVEPORT
State LA
ZIP 71104
Phone 3182212225
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 12/23/2025
Certificate Expiration Date 12/22/2027
Facility Type Physician Office
Lab Director SCOTT RITCH

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