23D0363376 CLIA NUMBER - PRIMARY CARE MEDICINE

Laboratory Demographics

  • CLIA Code: 23D0363376
  • Facility Name: PRIMARY CARE MEDICINE
  • Facility Address: 18451 W 12 MILE ROAD SUITE 101
    LATHRUP VILLAGE, MI
    ZIP 48076
  • Facility Phone: 248 865-0030
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BASMA M. ABU ASHOUR
  • NPI Number: 1568530053
  • Taxonomy: 207R00000X - Internal Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 23D0363376
LAB Type Physician Office
Facility Name PRIMARY CARE MEDICINE
Street 18451 W 12 MILE ROAD SUITE 101
City LATHRUP VILLAGE
State MI
ZIP 48076
Phone 248 865-0030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/29/2023
Certificate Expiration Date 10/28/2025
Facility Type Physician Office
Lab Director BASMA M. ABU ASHOUR

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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