23D0705401 CLIA NUMBER - COREWELL HEALTH FAMILY MEDICINE - 25631 LITTLE MACK AVE

Laboratory Demographics

  • CLIA Code: 23D0705401
  • Facility Name: COREWELL HEALTH FAMILY MEDICINE - 25631 LITTLE MACK AVE
  • Facility Address: 25631 LITTLE MACK SUITE 103
    SAINT CLAIR SHORES, MI
    ZIP 48081
  • Facility Phone: 586 443-2333
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHOSHAN P. ZOLO
  • NPI Number: 1699962142
  • Taxonomy: 261QP2300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 23D0705401
LAB Type Physician Office
Facility Name COREWELL HEALTH FAMILY MEDICINE - 25631 LITTLE MACK AVE
Street 25631 LITTLE MACK SUITE 103
City SAINT CLAIR SHORES
State MI
ZIP 48081
Phone 586 443-2333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/28/2025
Certificate Expiration Date 8/27/2027
Facility Type Physician Office
Lab Director SHOSHAN P. ZOLO

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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