19D0888311 CLIA NUMBER - PEDIATRIC KID MED, LLC

Laboratory Demographics

  • CLIA Code: 19D0888311
  • Facility Name: PEDIATRIC KID MED, LLC
  • Facility Address: 120 MEADOWCREST STREET, SUITE 245
    GRETNA, LA
    ZIP 70056
  • Facility Phone: 504 391-7690
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RAJESH K. SHARMA
  • NPI Number: 1386626356
  • Taxonomy: 2080N0001X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 19D0888311
LAB Type Physician Office
Facility Name PEDIATRIC KID MED, LLC
Street 120 MEADOWCREST STREET, SUITE 245
City GRETNA
State LA
ZIP 70056
Phone 504 391-7690
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/1/2024
Certificate Expiration Date 7/31/2026
Facility Type Physician Office
Lab Director RAJESH K. SHARMA

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