23D0697888 CLIA NUMBER - WESTERN MICHIGAN PEDIATRICS

Laboratory Demographics

  • CLIA Code: 23D0697888
  • Facility Name: WESTERN MICHIGAN PEDIATRICS
  • Facility Address: 721 KENMOOR AVENUE SE
    GRAND RAPIDS, MI
    ZIP 49546
  • Facility Phone: 616 949-6112
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHAWNA PIERCE
  • NPI Number: 1932227915
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 23D0697888
LAB Type Physician Office
Facility Name WESTERN MICHIGAN PEDIATRICS
Street 721 KENMOOR AVENUE SE
City GRAND RAPIDS
State MI
ZIP 49546
Phone 616 949-6112
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2025
Certificate Expiration Date 1/3/2027
Facility Type Physician Office
Lab Director SHAWNA PIERCE

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