23D1058523 CLIA NUMBER - CANTON CENTER PEDIATRICS, PC

Laboratory Demographics

CLIA Number: 23D1058523

Facility Name: CANTON CENTER PEDIATRICS, PC

Facility Address:
6492 N CANTON CENTER ROAD
CANTON, MI
ZIP 48187
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Facility Phone Number: 734 254-1900

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1487782462

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	23D1058523
LAB Type	Physician Office
Facility Name	CANTON CENTER PEDIATRICS, PC
Street	6492 N CANTON CENTER ROAD
City	CANTON
State	MI
ZIP	48187
Phone	734 254-1900
CertificateType	4
CertificateEffectiveDate	9/7/2022
CertificateExpirationDate	9/6/2024
FacilityType	Waiver

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