45D2039975 CLIA NUMBER - RIVER RIDGE PEDIATRICS,PA

Laboratory Demographics

  • CLIA Code: 45D2039975
  • Facility Name: RIVER RIDGE PEDIATRICS,PA
  • Facility Address: 1526 LEANDER ROAD
    GEORGETOWN, TX
    ZIP 78628
  • Facility Phone: 512 930-3985
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ADANA GIPSON
  • NPI Number: 1790042158
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2039975
LAB Type Physician Office
Facility Name RIVER RIDGE PEDIATRICS,PA
Street 1526 LEANDER ROAD
City GEORGETOWN
State TX
ZIP 78628
Phone 512 930-3985
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2024
Certificate Expiration Date 4/19/2026
Facility Type Physician Office
Lab Director ADANA GIPSON

Download Record

Download this CLIA record record in Text format: Export

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

Download this CLIA record record in XML format: Export

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