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23D0961584 CLIA NUMBER - KAVITHA PONDURI, MD, PC

Laboratory Demographics

CLIA Number: 23D0961584

Facility Name: KAVITHA PONDURI, MD, PC

Facility Address:
34659 W MICHIGAN AVENUE
WAYNE, MI
ZIP 48184
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Facility Phone Number: 734 722-2400

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1679568315

Taxonomy: 207R00000X - Internal Medicine
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

CLIA Record

Field Name Field Value
CLIA Number 23D0961584
LAB Type Physician Office
Facility Name KAVITHA PONDURI, MD, PC
Street 34659 W MICHIGAN AVENUE
City WAYNE
State MI
ZIP 48184
Phone 734 722-2400
CertificateType 4
CertificateEffectiveDate 6/10/2023
CertificateExpirationDate 6/9/2025
FacilityType Waiver

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