23D1063285 CLIA NUMBER - BLUE WATER CHILDREN'S HEALTH CARE, PLLC

Laboratory Demographics

  • CLIA Code: 23D1063285
  • Facility Name: BLUE WATER CHILDREN'S HEALTH CARE, PLLC
  • Facility Address: 1600 GRATIOT BLVD SUITE 8
    MARYSVILLE, MI
    ZIP 48040
  • Facility Phone: 810 432-8448
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: HEMALATA A. NANDI
  • NPI Number: 1073602835
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 23D1063285
LAB Type Physician Office
Facility Name BLUE WATER CHILDREN'S HEALTH CARE, PLLC
Street 1600 GRATIOT BLVD SUITE 8
City MARYSVILLE
State MI
ZIP 48040
Phone 810 432-8448
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Physician Office
Lab Director HEMALATA A. NANDI

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