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36D1069123 CLIA NUMBER - PEDIATRIC CENTER OF CANTON LLC

Laboratory Demographics

CLIA Number: 36D1069123

Facility Name: PEDIATRIC CENTER OF CANTON LLC

Facility Address:
1445 HARRISON AVENUE NW SUITE 300 & 306
CANTON, OH
ZIP 44708
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Facility Phone Number: 330 456-9939

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1194037150

Taxonomy: 208000000X - Pediatrics
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

CLIA Record

Field Name Field Value
CLIA Number 36D1069123
LAB Type Physician Office
Facility Name PEDIATRIC CENTER OF CANTON LLC
Street 1445 HARRISON AVENUE NW SUITE 300 & 306
City CANTON
State OH
ZIP 44708
Phone 330 456-9939
CertificateType 4
CertificateEffectiveDate 5/30/2023
CertificateExpirationDate 5/29/2025
FacilityType Waiver

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