30D2294116 CLIA NUMBER - PUDDLE DOCK PEDIATRICS PLLC

Laboratory Demographics

  • CLIA Code: 30D2294116
  • Facility Name: PUDDLE DOCK PEDIATRICS PLLC
  • Facility Address: 200 GRIFFIN RD, STE 12A
    PORTSMOUTH, NH
    ZIP 03801
  • Facility Phone: 603 457-7040
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALYSSA R. SMITH
  • NPI Number: 1376324533
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 30D2294116
LAB Type Physician Office
Facility Name PUDDLE DOCK PEDIATRICS PLLC
Street 200 GRIFFIN RD, STE 12A
City PORTSMOUTH
State NH
ZIP 03801
Phone 603 457-7040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/20/2023
Certificate Expiration Date 11/19/2025
Facility Type Physician Office
Lab Director ALYSSA R. SMITH

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