23D0704479 CLIA NUMBER - ROBERT H DICKASON DO

Laboratory Demographics

  • CLIA Code: 23D0704479
  • Facility Name: ROBERT H DICKASON DO
  • Facility Address: 5400 FORT STREET SUITE 210
    TRENTON, MI
    ZIP 48183
  • Facility Phone: 734 676-5353
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT H. DICKASON
  • NPI Number: 1710979869
  • Taxonomy: 208C00000X - Colon & Rectal Surgery

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CLIA Record

Field Name Field Value
CLIA Number 23D0704479
LAB Type Physician Office
Facility Name ROBERT H DICKASON DO
Street 5400 FORT STREET SUITE 210
City TRENTON
State MI
ZIP 48183
Phone 734 676-5353
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director ROBERT H. DICKASON

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