23D0367952 CLIA NUMBER - BRENTWOOD PEDIATRICS

Laboratory Demographics

  • CLIA Code: 23D0367952
  • Facility Name: BRENTWOOD PEDIATRICS
  • Facility Address: 33215 W SEVEN MILE ROAD
    LIVONIA, MI
    ZIP 48152
  • Facility Phone: 248 478-3200
  • Facility Type: Physician Office
  • Facility Type: Certificate of Compliance
  • Lab Director: AJEY V. GODBOLE
  • NPI Number: 1013188648
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 23D0367952
LAB Type Physician Office
Facility Name BRENTWOOD PEDIATRICS
Street 33215 W SEVEN MILE ROAD
City LIVONIA
State MI
ZIP 48152
Phone 248 478-3200
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Physician Office
Lab Director AJEY V. GODBOLE

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