23D0369160 CLIA NUMBER - MICHAEL L GAMBEL MD PC

Laboratory Demographics

  • CLIA Code: 23D0369160
  • Facility Name: MICHAEL L GAMBEL MD PC
  • Facility Address: 12100 DIX TOLEDO ROAD
    SOUTHGATE, MI
    ZIP 48195
  • Facility Phone: 734 282-5502
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MICHAEL L. GAMBEL
  • NPI Number: 1770585580
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D0369160
LAB Type Physician Office
Facility Name MICHAEL L GAMBEL MD PC
Street 12100 DIX TOLEDO ROAD
City SOUTHGATE
State MI
ZIP 48195
Phone 734 282-5502
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 10/14/2023
Certificate Expiration Date 10/13/2025
Facility Type Physician Office
Lab Director MICHAEL L. GAMBEL

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