34D2166259 CLIA NUMBER - AGES & STAGES PEDIATRICS, PLLC

Laboratory Demographics

  • CLIA Code: 34D2166259
  • Facility Name: AGES & STAGES PEDIATRICS, PLLC
  • Facility Address: 10340 PARK ROAD, SUITE B
    CHARLOTTE, NC
    ZIP 28210
  • Facility Phone: 980 498-3900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ADRIANA V. ROSADO-JIMENEZ
  • NPI Number: 1013489947
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 34D2166259
LAB Type Physician Office
Facility Name AGES & STAGES PEDIATRICS, PLLC
Street 10340 PARK ROAD, SUITE B
City CHARLOTTE
State NC
ZIP 28210
Phone 980 498-3900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/15/2025
Certificate Expiration Date 5/14/2027
Facility Type Physician Office
Lab Director ADRIANA V. ROSADO-JIMENEZ

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