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PEDIATRIC & ADOLESCENT CLINIC OF LOUISIANA LLC
NPI 1346092038
Clinic/Center - Rural Health in Vidalia, LA

Active since April 04, 2024CLIA 19D1005933 · Certificate of Compliance
1806 CARTER ST, VIDALIA, LA 71373(318) 336-7172(318) 336-7176 Get Directions Write a Review

NPPES record last updated: May 26, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 26, 2026, Apr 4, 2024 (2 updates tracked since 2024).

About Pediatric & Adolescent Clinic Of Louisiana Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PEDIATRIC & ADOLESCENT CLINIC OF LOUISIANA LLC (NPI 1346092038) is a healthcare organization registered as a rural health in Vidalia, Louisiana and active in the NPI registry since April 2024. The organization holds a CLIA Certificate of Compliance certificate valid through October 19, 2026 and lists David Timm, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1346092038
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NamePEDIATRIC & ADOLESCENT CLINIC OF LOUISIANA LLC
Location Address1806 CARTER STVidalia, LA 71373-3115
Mailing Address308 Highland BlvdNatchez, MS 39120-4611 · (601) 442-7676
Phone(318) 336-7172
Fax(318) 336-7176
Organization SubpartNo
Authorized OfficialDavid TimmMedical Director · (601) 442-7676
Enumeration DateApril 4, 2024
Last NPPES UpdateMay 26, 20262 updates tracked since enumeration
NPPES CertifiedMay 26, 2026
✔ NPI 1346092038 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
Also ListedPediatricsTaxonomy 208000000X
1806 CARTER ST, Vidalia, LA 71373
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 19D1005933

Pediatric And Adolescent Clinic Of Louisiana LLC · Vidalia, LA
Active · expires Oct 19, 2026
CLIA Number19D1005933
Laboratory TypeRural Health Clinic
Certificate Effective DateOctober 20, 2024
Certificate Expiration DateOctober 19, 2026
Laboratory DirectorDavid A. Timm
Laboratory Phone(318) 336-7172
Laboratory LocationPediatric And Adolescent Clinic Of Louisiana LLC1806 Carter Street, Vidalia, LA 71373
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID ALAN TIMM
Pediatrics
1806 CARTER ST
VIDALIA, LA 71373
Concordia Parish (318) 336-7172
NATCHEZ REGIONAL CLINIC
Family Medicine
1806 CARTER ST
VIDALIA, LA 71373
Concordia Parish (318) 336-8166
J KEVIN INGRAM MEDICAL, INC
Family Medicine
1806 CARTER ST
VIDALIA, LA 71373
Concordia Parish (318) 757-6526

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pediatric & Adolescent Clinic Of Louisiana LLC's NPI number?

The NPI number for Pediatric & Adolescent Clinic Of Louisiana LLC is 1346092038. It was assigned to this organization in the NPPES registry on April 4, 2024.

Where is Pediatric & Adolescent Clinic Of Louisiana LLC located?

Pediatric & Adolescent Clinic Of Louisiana LLC is located at 1806 Carter St, Vidalia, LA 71373. The listed phone number is (318) 336-7172.

What is Pediatric & Adolescent Clinic Of Louisiana LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Pediatric & Adolescent Clinic Of Louisiana LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 19D1005933) is associated with this NPI, valid through October 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Pediatric & Adolescent Clinic Of Louisiana LLC was last updated on May 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.