45D0482031 CLIA NUMBER - PEDIATRIC CLINIC, PA, THE

Laboratory Demographics

  • CLIA Code: 45D0482031
  • Facility Name: PEDIATRIC CLINIC, PA, THE
  • Facility Address: 2001 NORTH JEFFERSON SUITE 300
    MOUNT PLEASANT, TX
    ZIP 75455
  • Facility Phone: 903 572-9823
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: MICHAEL D. HENRY
  • NPI Number: 1437984259
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0482031
LAB Type Rural Health Clinic
Facility Name PEDIATRIC CLINIC, PA, THE
Street 2001 NORTH JEFFERSON SUITE 300
City MOUNT PLEASANT
State TX
ZIP 75455
Phone 903 572-9823
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type Rural Health Clinic
Lab Director MICHAEL D. HENRY

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