24D0399893 CLIA NUMBER - CENTRAL PEDIATRICS PA

Laboratory Demographics

CLIA Number: 24D0399893

Facility Name: CENTRAL PEDIATRICS PA

Facility Address:
9680 TAMARACK ROAD SUITE 100
WOODBURY, MN
ZIP 55125
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Facility Phone Number: 651 738-0470

Facility Type: Practitioner Other

Certificate Type: Accreditation

NPI Number: 1396721387

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	24D0399893
LAB Type	Practitioner Other
Facility Name	CENTRAL PEDIATRICS PA
Street	9680 TAMARACK ROAD SUITE 100
City	WOODBURY
State	MN
ZIP	55125
Phone	651 738-0470
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