23D2150560 CLIA NUMBER - GOGUE PEDIATRICS, P C

Laboratory Demographics

CLIA Number: 23D2150560

Facility Name: GOGUE PEDIATRICS, P C

Facility Address:
39242 DEQUINDRE ROAD SUITE 101
STERLING HEIGHTS, MI
ZIP 48310
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Facility Phone Number: 586 446-8060

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1265921191

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	23D2150560
LAB Type	Physician Office
Facility Name	GOGUE PEDIATRICS, P C
Street	39242 DEQUINDRE ROAD SUITE 101
City	STERLING HEIGHTS
State	MI
ZIP	48310
Phone	586 446-8060
CertificateType	4
CertificateEffectiveDate	6/27/2022
CertificateExpirationDate	6/26/2024
FacilityType	Waiver

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