23D2109950 CLIA NUMBER - PRATIMA BOINEPALLI MD, PLLC

Laboratory Demographics

  • CLIA Code: 23D2109950
  • Facility Name: PRATIMA BOINEPALLI MD, PLLC
  • Facility Address: 3945 OKEMOS ROAD SUITE A1
    OKEMOS, MI
    ZIP 48864
  • Facility Phone: 517 347-4660
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PRATIMA BOINEPALLI
  • NPI Number: 1821463175
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2109950
LAB Type Physician Office
Facility Name PRATIMA BOINEPALLI MD, PLLC
Street 3945 OKEMOS ROAD SUITE A1
City OKEMOS
State MI
ZIP 48864
Phone 517 347-4660
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/7/2024
Certificate Expiration Date 3/6/2026
Facility Type Physician Office
Lab Director PRATIMA BOINEPALLI

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