45D2124872 CLIA NUMBER - NORTHSIDE PEDIATRICS ASSOCIATES PA

Laboratory Demographics

  • CLIA Code: 45D2124872
  • Facility Name: NORTHSIDE PEDIATRICS ASSOCIATES PA
  • Facility Address: 500 MEDICAL CENTER BLVD, SUITE 350
    CONROE, TX
    ZIP 77304
  • Facility Phone: 806 626-3808
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AYOTUNDE FAWEYA
  • NPI Number: 1669928883
  • Taxonomy: 208000000X - Pediatrics

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2124872
LAB Type Physician Office
Facility Name NORTHSIDE PEDIATRICS ASSOCIATES PA
Street 500 MEDICAL CENTER BLVD, SUITE 350
City CONROE
State TX
ZIP 77304
Phone 806 626-3808
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2025
Certificate Expiration Date 1/25/2027
Facility Type Physician Office
Lab Director AYOTUNDE FAWEYA

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