44D0674233 CLIA NUMBER - YOUTHCARE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 44D0674233
  • Facility Name: YOUTHCARE PEDIATRICS
  • Facility Address: 212 MIDWAY MEDICAL PARK
    BRISTOL, TN
    ZIP 37620
  • Facility Phone: 423 968-4007
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: THOMAS E. MITORAJ MD
  • NPI Number: 1275841488
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 44D0674233
LAB Type Physician Office
Facility Name YOUTHCARE PEDIATRICS
Street 212 MIDWAY MEDICAL PARK
City BRISTOL
State TN
ZIP 37620
Phone 423 968-4007
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/14/2024
Certificate Expiration Date 4/13/2026
Facility Type Physician Office
Lab Director THOMAS E. MITORAJ MD

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