23D0953888 CLIA NUMBER - PEDIATRIC CARE CORNER, PC

Laboratory Demographics

CLIA Number: 23D0953888

Facility Name: PEDIATRIC CARE CORNER, PC

Facility Address:
2300 HAGGERTY ROAD SUITE 2110
WEST BLOOMFIELD, MI
ZIP 48323
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Facility Phone Number: 248 926-1411

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1508864687

Taxonomy: 2080A0000X - Pediatrics
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.

CLIA Record

Field Name	Field Value
CLIA Number	23D0953888
LAB Type	Physician Office
Facility Name	PEDIATRIC CARE CORNER, PC
Street	2300 HAGGERTY ROAD SUITE 2110
City	WEST BLOOMFIELD
State	MI
ZIP	48323
Phone	248 926-1411
CertificateType	4
CertificateEffectiveDate	1/1/2023
CertificateExpirationDate	12/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024