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SOUTHSIDE PEDIATRIC CENTER
NPI 1477750024
Clinic/Center in Colonial Heights, VA

Active since June 28, 2007CLIA 49D1058689 · Waiver
400 SOUTHPARK BLVD STE D, COLONIAL HEIGHTS, VA 23834(804) 520-8135(804) 520-8092 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Southside Pediatric Center NPPES

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

SOUTHSIDE PEDIATRIC CENTER (NPI 1477750024) is a healthcare organization registered as a clinic/center in Colonial Heights, Virginia and active in the NPI registry since June 2007. The organization holds a CLIA Waiver certificate valid through June 19, 2028 and lists Mary Catherine Arrieta, President, as its authorized official.

NPPES Registry Identity

NPI1477750024
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameSOUTHSIDE PEDIATRIC CENTER
Location Address400 SOUTHPARK BLVD STE DColonial Heights, VA 23834-2974
Mailing Address400 Southpark Blvd Ste DColonial Heights, VA 23834-2974 · (804) 520-8135 · Fax (804) 520-8092
Phone(804) 520-8135
Fax(804) 520-8092
Organization SubpartNo
Authorized OfficialMary Catherine ArrietaPresident · (804) 520-8135
Enumeration DateJune 28, 2007
Last NPPES UpdateAugust 22, 2020
✔ NPI 1477750024 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
400 SOUTHPARK BLVD STE D, Colonial Heights, VA 23834
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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 Waiver 49D1058689

Southside Pediatric Center · Petersburg, VA
Active · expires Jun 19, 2028
CLIA Number49D1058689
Laboratory TypePhysician Office
Certificate Effective DateJune 20, 2026
Certificate Expiration DateJune 19, 2028
Laboratory DirectorMary C. Arrieta, MD
Laboratory Phone(804) 520-8135
Laboratory LocationSouthside Pediatric Center34 Medical Park Blvd Suite F, Petersburg, VA 23805
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Southside Pediatric Center's NPI number?

The NPI number for Southside Pediatric Center is 1477750024. It was assigned to this organization in the NPPES registry on June 28, 2007.

Where is Southside Pediatric Center located?

Southside Pediatric Center is located at 400 Southpark Blvd Ste D, Colonial Heights, VA 23834. The listed phone number is (804) 520-8135.

What is Southside Pediatric Center's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Southside Pediatric Center hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 49D1058689) is associated with this NPI, valid through June 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southside Pediatric Center was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.