45D1005567 CLIA NUMBER - PEDIATRIC PRACTICE ASSOCIATION

Laboratory Demographics

CLIA Number: 45D1005567

Facility Name: PEDIATRIC PRACTICE ASSOCIATION

Facility Address:
201 EAST 2ND STREET
RIO GRANDE CITY, TX
ZIP 78582
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Facility Phone Number: 956 488-1200

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1700994217

Taxonomy: 363AM0700X - Physician Assistant

CLIA Record

Field Name	Field Value
CLIA Number	45D1005567
LAB Type	Physician Office
Facility Name	PEDIATRIC PRACTICE ASSOCIATION
Street	201 EAST 2ND STREET
City	RIO GRANDE CITY
State	TX
ZIP	78582
Phone	956 488-1200
CertificateType	1
CertificateEffectiveDate	12/14/2023
CertificateExpirationDate	12/13/2025
FacilityType	Accreditation

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