23D1086213 CLIA NUMBER - BIRMINGHAM PEDIATRICS + WELLNESS CENTER MOLLY O'SHEA MD PLLC

Laboratory Demographics

CLIA Number: 23D1086213

Facility Name: BIRMINGHAM PEDIATRICS + WELLNESS CENTER MOLLY O'SHEA MD PLLC

Facility Address:
6785 TELEGRAPH ROAD SUITE 350
BLOOMFIELD HILLS, MI
ZIP 48301
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Facility Phone Number: 248 816-2558

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1669709960

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D1086213
LAB Type	Physician Office
Facility Name	BIRMINGHAM PEDIATRICS + WELLNESS CENTER MOLLY O'SHEA MD PLLC
Street	6785 TELEGRAPH ROAD SUITE 350
City	BLOOMFIELD HILLS
State	MI
ZIP	48301
Phone	248 816-2558
CertificateType	4
CertificateEffectiveDate	9/7/2023
CertificateExpirationDate	9/6/2025
FacilityType	Waiver

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