45D2308218 CLIA NUMBER - SUNNYSIDE PEDIATRICS PLLC

Laboratory Demographics

  • CLIA Code: 45D2308218
  • Facility Name: SUNNYSIDE PEDIATRICS PLLC
  • Facility Address: 2511 E CORRAL AVE
    KINGSVILLE, TX
    ZIP 78363
  • Facility Phone: 361 246-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JESSICA ACEVEDO-GRACIA
  • NPI Number: 1720847767
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2308218
LAB Type Physician Office
Facility Name SUNNYSIDE PEDIATRICS PLLC
Street 2511 E CORRAL AVE
City KINGSVILLE
State TX
ZIP 78363
Phone 361 246-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Physician Office
Lab Director JESSICA ACEVEDO-GRACIA

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