34D2299011 CLIA NUMBER - PEDIATRICS PLUS

Laboratory Demographics

CLIA Number: 34D2299011

Facility Name: PEDIATRICS PLUS

Facility Address:
2420 S CROATAN HWY SUITE D
NAGS HEAD, NC
ZIP 27959
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Facility Phone Number: 252 715-1129

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1417719378

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	34D2299011
LAB Type	Practitioner Other
Facility Name	PEDIATRICS PLUS
Street	2420 S CROATAN HWY SUITE D
City	NAGS HEAD
State	NC
ZIP	27959
Phone	252 715-1129
CertificateType	4
CertificateEffectiveDate	2/13/2024
CertificateExpirationDate	2/12/2026
FacilityType	Waiver

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