23D0369062 CLIA NUMBER - ADVANCED DERMATOLOGY OF MICHIGAN

Laboratory Demographics

  • CLIA Code: 23D0369062
  • Facility Name: ADVANCED DERMATOLOGY OF MICHIGAN
  • Facility Address: 1500 EUREKA ROAD
    WYANDOTTE, MI
    ZIP 48192
  • Facility Phone: 407 284-3407
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: MICHAEL W. WHITWORTH
  • NPI Number: 1881224749
  • Taxonomy: 225700000X - Massage Therapist

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CLIA Record

Field Name Field Value
CLIA Number 23D0369062
LAB Type Physician Office
Facility Name ADVANCED DERMATOLOGY OF MICHIGAN
Street 1500 EUREKA ROAD
City WYANDOTTE
State MI
ZIP 48192
Phone 407 284-3407
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 9/21/2025
Certificate Expiration Date 9/20/2027
Facility Type Physician Office
Lab Director MICHAEL W. WHITWORTH

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