23D2100578 CLIA NUMBER - MACOMB MEDICAL PEDIATRICS

Laboratory Demographics

  • CLIA Code: 23D2100578
  • Facility Name: MACOMB MEDICAL PEDIATRICS
  • Facility Address: 43475 DALCOMA DR SUITE 140
    CLINTON TOWNSHIP, MI
    ZIP 48038
  • Facility Phone: 586 263-1818
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BHAVANA R. VYAS
  • NPI Number: 1427430677
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 23D2100578
LAB Type Physician Office
Facility Name MACOMB MEDICAL PEDIATRICS
Street 43475 DALCOMA DR SUITE 140
City CLINTON TOWNSHIP
State MI
ZIP 48038
Phone 586 263-1818
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2025
Certificate Expiration Date 8/17/2027
Facility Type Physician Office
Lab Director BHAVANA R. VYAS

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