23D0365434 CLIA NUMBER - HENRY FORD ST CLAIR ADULT MEDICINE SPECIALISTS - KERCHAVEL

Laboratory Demographics

  • CLIA Code: 23D0365434
  • Facility Name: HENRY FORD ST CLAIR ADULT MEDICINE SPECIALISTS - KERCHAVEL
  • Facility Address: 17141 KERCHEVAL AVENUE
    GROSSE POINTE, MI
    ZIP 48230
  • Facility Phone: 313 642-4990
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JULIA K. TESCH
  • NPI Number: 1174725659
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 23D0365434
LAB Type Physician Office
Facility Name HENRY FORD ST CLAIR ADULT MEDICINE SPECIALISTS - KERCHAVEL
Street 17141 KERCHEVAL AVENUE
City GROSSE POINTE
State MI
ZIP 48230
Phone 313 642-4990
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/5/2025
Certificate Expiration Date 6/4/2027
Facility Type Physician Office
Lab Director JULIA K. TESCH

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