23D1037775 CLIA NUMBER - SACRED HEART PEDIATRICS

Laboratory Demographics

  • CLIA Code: 23D1037775
  • Facility Name: SACRED HEART PEDIATRICS
  • Facility Address: 11755 E MICHIGAN AVENUE
    GRASS LAKE, MI
    ZIP 49240
  • Facility Phone: 517 522-6408
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOEL B. DINVERNO
  • NPI Number: 1053674184
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 23D1037775
LAB Type Physician Office
Facility Name SACRED HEART PEDIATRICS
Street 11755 E MICHIGAN AVENUE
City GRASS LAKE
State MI
ZIP 49240
Phone 517 522-6408
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2025
Certificate Expiration Date 3/3/2027
Facility Type Physician Office
Lab Director JOEL B. DINVERNO

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