25D2103437 CLIA NUMBER - DELTA PEDIATRIC CARE LLC

Laboratory Demographics

  • CLIA Code: 25D2103437
  • Facility Name: DELTA PEDIATRIC CARE LLC
  • Facility Address: 526 FAIRVIEW
    GREENVILLE, MS
    ZIP 38701
  • Facility Phone: 318 512-9218
  • Facility Type: Other - PRESCRIBED PEDIATRIC
  • Facility Type: Waiver
  • Lab Director: MAUREEN E. GALLAGHER
  • NPI Number: 1437523511
  • Taxonomy: 3140N1450X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 25D2103437
LAB Type Other - PRESCRIBED PEDIATRIC
Facility Name DELTA PEDIATRIC CARE LLC
Street 526 FAIRVIEW
City GREENVILLE
State MS
ZIP 38701
Phone 318 512-9218
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/13/2025
Certificate Expiration Date 10/12/2027
Facility Type Other - PRESCRIBED PEDIATRIC
Lab Director MAUREEN E. GALLAGHER

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