23D0677273 CLIA NUMBER - PORT CITY PEDIATRICS, PLC

Laboratory Demographics

  • CLIA Code: 23D0677273
  • Facility Name: PORT CITY PEDIATRICS, PLC
  • Facility Address: 1455 FARR ROAD
    NORTON SHORES, MI
    ZIP 49444
  • Facility Phone: 231 220-2245
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RICHARD J. GOLZ
  • NPI Number: 1043741424
  • Taxonomy: 1223G0001X - Dentist

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 23D0677273
LAB Type Physician Office
Facility Name PORT CITY PEDIATRICS, PLC
Street 1455 FARR ROAD
City NORTON SHORES
State MI
ZIP 49444
Phone 231 220-2245
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Physician Office
Lab Director RICHARD J. GOLZ

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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