23D0369176 CLIA NUMBER - CHILD & ADOLESCENT CENTER, P C

Laboratory Demographics

  • CLIA Code: 23D0369176
  • Facility Name: CHILD & ADOLESCENT CENTER, P C
  • Facility Address: 15350 TRENTON RD
    SOUTHGATE, MI
    ZIP 48195
  • Facility Phone: 734 283-4616
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PETRONIO C. YADAO
  • NPI Number: 1952498875
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 23D0369176
LAB Type Physician Office
Facility Name CHILD & ADOLESCENT CENTER, P C
Street 15350 TRENTON RD
City SOUTHGATE
State MI
ZIP 48195
Phone 734 283-4616
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2025
Certificate Expiration Date 10/16/2027
Facility Type Physician Office
Lab Director PETRONIO C. YADAO

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