23D0704922 CLIA NUMBER - EXECUTIVE HEALTH PC

Laboratory Demographics

  • CLIA Code: 23D0704922
  • Facility Name: EXECUTIVE HEALTH PC
  • Facility Address: 1213 MASON STREET STE #3
    DEARBORN, MI
    ZIP 48124
  • Facility Phone: 313 278-2800
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SADIQ H. RIZVI MD
  • NPI Number: 1528445632
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D0704922
LAB Type Physician Office
Facility Name EXECUTIVE HEALTH PC
Street 1213 MASON STREET STE #3
City DEARBORN
State MI
ZIP 48124
Phone 313 278-2800
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 SADIQ H. RIZVI MD

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