23D2276880 CLIA NUMBER - PEDIATRIC SPECIAL CARE, INC DBA AVEANNA

Laboratory Demographics

  • CLIA Code: 23D2276880
  • Facility Name: PEDIATRIC SPECIAL CARE, INC DBA AVEANNA
  • Facility Address: 22260 HAGGERTY ROAD SUITE 180
    NORTHVILLE, MI
    ZIP 48167
  • Facility Phone: 248 557-4800
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: AMY M. FOMIN
  • NPI Number: 1891745808
  • Taxonomy: 251J00000X - Nursing Care

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CLIA Record

Field Name Field Value
CLIA Number 23D2276880
LAB Type Home Health Agency
Facility Name PEDIATRIC SPECIAL CARE, INC DBA AVEANNA
Street 22260 HAGGERTY ROAD SUITE 180
City NORTHVILLE
State MI
ZIP 48167
Phone 248 557-4800
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/16/2025
Certificate Expiration Date 2/15/2027
Facility Type Home Health Agency
Lab Director AMY M. FOMIN

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