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19D0463623 CLIA NUMBER - MID CITY PEDIATRIC CLINIC

Laboratory Demographics

CLIA Number: 19D0463623

Facility Name: MID CITY PEDIATRIC CLINIC

Facility Address:
2225 LINE AVENUE
SHREVEPORT, LA
ZIP 71104
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Facility Phone Number: 318 221-2225

Facility Type: Physician Office

Certificate Type: Accreditation
NPI Number: 1902811888

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

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 318 221-2225
CertificateType 1
CertificateEffectiveDate 12/23/2023
CertificateExpirationDate 12/22/2025
FacilityType Accreditation

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