45D2165012 CLIA NUMBER - SUNNYSIDE PEDIATRICS

Laboratory Demographics

CLIA Number: 45D2165012

Facility Name: SUNNYSIDE PEDIATRICS

Facility Address:
13310 LEOPARD STREET, SUITE 27
CORPUS CHRISTI, TX
ZIP 78410
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Facility Phone Number: 361 424-3355

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1073289096

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	45D2165012
LAB Type	Physician Office
Facility Name	SUNNYSIDE PEDIATRICS
Street	13310 LEOPARD STREET, SUITE 27
City	CORPUS CHRISTI
State	TX
ZIP	78410
Phone	361 424-3355
CertificateType	4
CertificateEffectiveDate	4/17/2023
CertificateExpirationDate	4/16/2025
FacilityType	Waiver

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