23D2103297 CLIA NUMBER - BRANCH PEDIATRIC & ADOLESCENT MEDICINE PC

Laboratory Demographics

  • CLIA Code: 23D2103297
  • Facility Name: BRANCH PEDIATRIC & ADOLESCENT MEDICINE PC
  • Facility Address: 390 E CHICAGO STREET
    COLDWATER, MI
    ZIP 49036
  • Facility Phone: 517 924-1465
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MEHALAI ARIVOLI
  • NPI Number: 1457893430
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2103297
LAB Type Physician Office
Facility Name BRANCH PEDIATRIC & ADOLESCENT MEDICINE PC
Street 390 E CHICAGO STREET
City COLDWATER
State MI
ZIP 49036
Phone 517 924-1465
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2025
Certificate Expiration Date 10/8/2027
Facility Type Physician Office
Lab Director MEHALAI ARIVOLI

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