45D0973224 CLIA NUMBER - PEDIATRIC CLINIC OF LA PORTE, PA

Laboratory Demographics

CLIA Number: 45D0973224

Facility Name: PEDIATRIC CLINIC OF LA PORTE, PA

Facility Address:
10407 WEST FAIRMONT PARKWAY SUITE B
LA PORTE, TX
ZIP 77571
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Facility Phone Number: 281 867-0291

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1700064292

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	45D0973224
LAB Type	Physician Office
Facility Name	PEDIATRIC CLINIC OF LA PORTE, PA
Street	10407 WEST FAIRMONT PARKWAY SUITE B
City	LA PORTE
State	TX
ZIP	77571
Phone	281 867-0291
CertificateType	4
CertificateEffectiveDate	4/28/2024
CertificateExpirationDate	4/27/2026
FacilityType	Waiver

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