23D0979608 CLIA NUMBER - MAUREEN A KELLY, MD, PLLC

Laboratory Demographics

  • CLIA Code: 23D0979608
  • Facility Name: MAUREEN A KELLY, MD, PLLC
  • Facility Address: 43205 WOODWARD AVENUE
    BLOOMFIELD HILLS, MI
    ZIP 48302
  • Facility Phone: 248 451-0600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MAUREEN A. KELLY
  • NPI Number: 1609874064
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 23D0979608
LAB Type Physician Office
Facility Name MAUREEN A KELLY, MD, PLLC
Street 43205 WOODWARD AVENUE
City BLOOMFIELD HILLS
State MI
ZIP 48302
Phone 248 451-0600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2024
Certificate Expiration Date 10/25/2026
Facility Type Physician Office
Lab Director MAUREEN A. KELLY

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