34D2142887 CLIA NUMBER - KIDZCARE PEDIATRICS, PC

Laboratory Demographics

  • CLIA Code: 34D2142887
  • Facility Name: KIDZCARE PEDIATRICS, PC
  • Facility Address: 112 MEDICAL VILLAGE DRIVE, SUITE D
    WALLACE, NC
    ZIP 28466
  • Facility Phone: 910 665-1437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JAIN C. ASHOKKUMAR
  • NPI Number: 1972015097
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 34D2142887
LAB Type Physician Office
Facility Name KIDZCARE PEDIATRICS, PC
Street 112 MEDICAL VILLAGE DRIVE, SUITE D
City WALLACE
State NC
ZIP 28466
Phone 910 665-1437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2024
Certificate Expiration Date 1/21/2026
Facility Type Physician Office
Lab Director JAIN C. ASHOKKUMAR

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