25D2305720 CLIA NUMBER - PEDIATRICS PLUS, LLC

Laboratory Demographics

  • CLIA Code: 25D2305720
  • Facility Name: PEDIATRICS PLUS, LLC
  • Facility Address: 7215 SOUTH SIWELL ROAD SUITE B
    BYRAM, MS
    ZIP 39272
  • Facility Phone: 601 201-4419
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: STEPHANIE O. BOYDSTON
  • NPI Number: 1063266823
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 25D2305720
LAB Type Practitioner Other
Facility Name PEDIATRICS PLUS, LLC
Street 7215 SOUTH SIWELL ROAD SUITE B
City BYRAM
State MS
ZIP 39272
Phone 601 201-4419
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2024
Certificate Expiration Date 6/4/2026
Facility Type Practitioner Other
Lab Director STEPHANIE O. BOYDSTON

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