33D1080740 CLIA NUMBER - WAKEFIELD PEDIATRICS PLLC

Laboratory Demographics

CLIA Number: 33D1080740

Facility Name: WAKEFIELD PEDIATRICS PLLC

Facility Address:
4813 WHITE PLAINS ROAD
BRONX, NY
ZIP 10470
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Facility Phone Number: 718 882-2835

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1558532796

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	33D1080740
LAB Type	Physician Office
Facility Name	WAKEFIELD PEDIATRICS PLLC
Street	4813 WHITE PLAINS ROAD
City	BRONX
State	NY
ZIP	10470
Phone	718 882-2835
CertificateType	4
CertificateEffectiveDate	3/1/2024
CertificateExpirationDate	2/28/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024