23D0973091 CLIA NUMBER - COREWELL HEALTH UROLOGY - ST JOSEPH

Laboratory Demographics

CLIA Number: 23D0973091

Facility Name: COREWELL HEALTH UROLOGY - ST JOSEPH

Facility Address:
815 ST JOSEPH AVENUE
ST JOSEPH, MI
ZIP 49085
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Facility Phone Number: 269 983-3455

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1972880920

Taxonomy: 2080P0205X - Pediatrics
A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands.

CLIA Record

Field Name	Field Value
CLIA Number	23D0973091
LAB Type	Physician Office
Facility Name	COREWELL HEALTH UROLOGY - ST JOSEPH
Street	815 ST JOSEPH AVENUE
City	ST JOSEPH
State	MI
ZIP	49085
Phone	269 983-3455
CertificateType	3
CertificateEffectiveDate	1/29/2023
CertificateExpirationDate	1/28/2025
FacilityType	PPMP

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