23D2023019 CLIA NUMBER - GREAT LAKES PEDIATRIC

Laboratory Demographics

  • CLIA Code: 23D2023019
  • Facility Name: GREAT LAKES PEDIATRIC
  • Facility Address: 13430 13 MILE
    WARREN, MI
    ZIP 48088
  • Facility Phone: 586 427-1351
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SUNDUS RUMMARI-ASKAR
  • NPI Number: 1417126715
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 23D2023019
LAB Type Physician Office
Facility Name GREAT LAKES PEDIATRIC
Street 13430 13 MILE
City WARREN
State MI
ZIP 48088
Phone 586 427-1351
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Physician Office
Lab Director SUNDUS RUMMARI-ASKAR

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