23D0365504 CLIA NUMBER - HENRY FORD FAMILY MEDICINE - ST CLAIR SHORES

Laboratory Demographics

  • CLIA Code: 23D0365504
  • Facility Name: HENRY FORD FAMILY MEDICINE - ST CLAIR SHORES
  • Facility Address: 24911 LITTLE MACK SUITE C
    ST CLAIR SHORES, MI
    ZIP 48080
  • Facility Phone: 586 447-9068
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MARY K. MURPHY
  • NPI Number: 1265526669
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D0365504
LAB Type Physician Office
Facility Name HENRY FORD FAMILY MEDICINE - ST CLAIR SHORES
Street 24911 LITTLE MACK SUITE C
City ST CLAIR SHORES
State MI
ZIP 48080
Phone 586 447-9068
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director MARY K. MURPHY

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