23D0362954 CLIA NUMBER - TRINITY HEALTH IHA MEDICAL GROUP, PRIMARY CARE BLOOMFIELD

Laboratory Demographics

  • CLIA Code: 23D0362954
  • Facility Name: TRINITY HEALTH IHA MEDICAL GROUP, PRIMARY CARE BLOOMFIELD
  • Facility Address: 43097 WOODWARD SUITE 100
    BLOOMFIELD TOWNSHIP, MI
    ZIP 48302
  • Facility Phone: 248 836-0040
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RHONDA GUMMA
  • NPI Number: 1003277229
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 23D0362954
LAB Type Physician Office
Facility Name TRINITY HEALTH IHA MEDICAL GROUP, PRIMARY CARE BLOOMFIELD
Street 43097 WOODWARD SUITE 100
City BLOOMFIELD TOWNSHIP
State MI
ZIP 48302
Phone 248 836-0040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2025
Certificate Expiration Date 1/21/2027
Facility Type Physician Office
Lab Director RHONDA GUMMA

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