52D2083729 CLIA NUMBER - DELAFIELD PEDIATRICS

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Laboratory Demographics

CLIA Number: 52D2083729

Facility Name: DELAFIELD PEDIATRICS

Facility Address:
3195 HILLSIDE DR
DELAFIELD, WI
ZIP 53018
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Facility Phone Number: 414 266-5432

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1407208002

Taxonomy: 1223G0001X - Dentist
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

CLIA Record

Field Name	Field Value
CLIA Number	52D2083729
LAB Type	Physician Office
Facility Name	DELAFIELD PEDIATRICS
Street	3195 HILLSIDE DR
City	DELAFIELD
State	WI
ZIP	53018
Phone	414 266-5432
CertificateType	4
CertificateEffectiveDate	9/11/2022
CertificateExpirationDate	9/10/2024
FacilityType	Waiver

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