Healther Providers Data Logo

41D0083005 CLIA NUMBER - SOUTH COUNTY PEDIATRIC GROUP

Laboratory Demographics

CLIA Number: 41D0083005

Facility Name: SOUTH COUNTY PEDIATRIC GROUP

Facility Address:
360 KINGSTOWN RD SUITE 101
NARRAGANSETT, RI
ZIP 02882
Get Directions

Facility Phone Number: 401 786-6492

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1326160102

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 41D0083005
LAB Type Physician Office
Facility Name SOUTH COUNTY PEDIATRIC GROUP
Street 360 KINGSTOWN RD SUITE 101
City NARRAGANSETT
State RI
ZIP 02882
Phone 401 786-6492
CertificateType 4
CertificateEffectiveDate 10/24/2022
CertificateExpirationDate 10/23/2024
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

Download this CLIA NUMBER record in Excel (CSV) format: Export

Download this CLIA NUMBER record in XML format: Export

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