23D0365302 CLIA NUMBER - VILLAGE PEDIATRICS PLLC

Laboratory Demographics

  • CLIA Code: 23D0365302
  • Facility Name: VILLAGE PEDIATRICS PLLC
  • Facility Address: 31815 SOUTHFIELD ROAD SUITE 10
    BEVERLY HILLS, MI
    ZIP 48025
  • Facility Phone: 248 644-2700
  • Facility Type: Independent
  • Facility Type: Waiver
  • Lab Director: MARLENE M. ROTH
  • NPI Number: 1962780767
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 23D0365302
LAB Type Independent
Facility Name VILLAGE PEDIATRICS PLLC
Street 31815 SOUTHFIELD ROAD SUITE 10
City BEVERLY HILLS
State MI
ZIP 48025
Phone 248 644-2700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/4/2024
Certificate Expiration Date 6/3/2026
Facility Type Independent
Lab Director MARLENE M. ROTH

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