23D0364428 CLIA NUMBER - EASTLAKE PEDIATRICS PC

Laboratory Demographics

  • CLIA Code: 23D0364428
  • Facility Name: EASTLAKE PEDIATRICS PC
  • Facility Address: 18325 E 10 MILE ROAD SUITE 100
    ROSEVILLE, MI
    ZIP 48066
  • Facility Phone: 810 776-1010
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VESNA L. ROI
  • NPI Number: 1215115829
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 23D0364428
LAB Type Physician Office
Facility Name EASTLAKE PEDIATRICS PC
Street 18325 E 10 MILE ROAD SUITE 100
City ROSEVILLE
State MI
ZIP 48066
Phone 810 776-1010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Physician Office
Lab Director VESNA L. ROI

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