47D0670466 CLIA NUMBER - LAKESIDE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 47D0670466
  • Facility Name: LAKESIDE PEDIATRICS
  • Facility Address: 128 LAKESIDE AVE SUITE 115
    BURLINGTON, VT
    ZIP 05401
  • Facility Phone: 802 860-1928
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: GREGORY CONNOLLY
  • NPI Number: 1043321896
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 47D0670466
LAB Type Physician Office
Facility Name LAKESIDE PEDIATRICS
Street 128 LAKESIDE AVE SUITE 115
City BURLINGTON
State VT
ZIP 05401
Phone 802 860-1928
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 10/21/2024
Certificate Expiration Date 10/20/2026
Facility Type Physician Office
Lab Director GREGORY CONNOLLY

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