23D0368143 CLIA NUMBER - EVELYN ECCLES MD

Laboratory Demographics

  • CLIA Code: 23D0368143
  • Facility Name: EVELYN ECCLES MD
  • Facility Address: 122 W MAIN
    MANCHESTER, MI
    ZIP 48158
  • Facility Phone: 734 428-8381
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EVELYN ECCLES
  • NPI Number: 1366533689
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D0368143
LAB Type Physician Office
Facility Name EVELYN ECCLES MD
Street 122 W MAIN
City MANCHESTER
State MI
ZIP 48158
Phone 734 428-8381
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Physician Office
Lab Director EVELYN ECCLES

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