34D2217055 CLIA NUMBER - CALLISTO PEDIATRICS, PLLC

Laboratory Demographics

  • CLIA Code: 34D2217055
  • Facility Name: CALLISTO PEDIATRICS, PLLC
  • Facility Address: 320 SEAGLE STREET SUITE # 10
    HUNTERSVILLE, NC
    ZIP 28078
  • Facility Phone: 704 368-4351
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TARA MOON
  • NPI Number: 1447847975
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 34D2217055
LAB Type Physician Office
Facility Name CALLISTO PEDIATRICS, PLLC
Street 320 SEAGLE STREET SUITE # 10
City HUNTERSVILLE
State NC
ZIP 28078
Phone 704 368-4351
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2025
Certificate Expiration Date 3/17/2027
Facility Type Physician Office
Lab Director TARA MOON

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