26D0870919 CLIA NUMBER - RIVERSIDE PEDIATRICS, INC

Laboratory Demographics

  • CLIA Code: 26D0870919
  • Facility Name: RIVERSIDE PEDIATRICS, INC
  • Facility Address: 2873 S INGRAM AVE
    SEDALIA, MO
    ZIP 65301
  • Facility Phone: 660 826-0027
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: ALI MANSOUR EBRAHIMI
  • NPI Number: 1790742971
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 26D0870919
LAB Type Physician Office
Facility Name RIVERSIDE PEDIATRICS, INC
Street 2873 S INGRAM AVE
City SEDALIA
State MO
ZIP 65301
Phone 660 826-0027
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 4/8/2024
Certificate Expiration Date 4/7/2026
Facility Type Physician Office
Lab Director ALI MANSOUR EBRAHIMI

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