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36D2112173 CLIA NUMBER - SHELBY PEDIATRICS LLC

Laboratory Demographics

CLIA Number: 36D2112173

Facility Name: SHELBY PEDIATRICS LLC

Facility Address:
1431 N MAIN AVE
SIDNEY, OH
ZIP 45365
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Facility Phone Number: 937 419-8687

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1568818029

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 36D2112173
LAB Type Physician Office
Facility Name SHELBY PEDIATRICS LLC
Street 1431 N MAIN AVE
City SIDNEY
State OH
ZIP 45365
Phone 937 419-8687
CertificateType 4
CertificateEffectiveDate 4/25/2024
CertificateExpirationDate 4/24/2026
FacilityType Waiver

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