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23D1089431 CLIA NUMBER - COREWELL HEALTH PEDIATRIC ADOLESCENT MEDICINE - BARCLAY

Laboratory Demographics

CLIA Number: 23D1089431

Facility Name: COREWELL HEALTH PEDIATRIC ADOLESCENT MEDICINE - BARCLAY

Facility Address:
330 BARCLAY AVE NE SUITE 203
GRAND RAPIDS, MI
ZIP 49503
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Facility Phone Number: 616 391-2123

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1265732861

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 23D1089431
LAB Type Physician Office
Facility Name COREWELL HEALTH PEDIATRIC ADOLESCENT MEDICINE - BARCLAY
Street 330 BARCLAY AVE NE SUITE 203
City GRAND RAPIDS
State MI
ZIP 49503
Phone 616 391-2123
CertificateType 3
CertificateEffectiveDate 9/17/2022
CertificateExpirationDate 9/16/2024
FacilityType PPMP

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