23D0715955 CLIA NUMBER - MIDWEST CARDIOLOGY PC

Laboratory Demographics

  • CLIA Code: 23D0715955
  • Facility Name: MIDWEST CARDIOLOGY PC
  • Facility Address: 30626 FORD ROAD
    GARDEN CITY, MI
    ZIP 48135
  • Facility Phone: 734 261-9211
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: WILLIAM R. BACK DO
  • NPI Number: 1952317646
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D0715955
LAB Type Physician Office
Facility Name MIDWEST CARDIOLOGY PC
Street 30626 FORD ROAD
City GARDEN CITY
State MI
ZIP 48135
Phone 734 261-9211
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/9/2025
Certificate Expiration Date 10/8/2027
Facility Type Physician Office
Lab Director WILLIAM R. BACK DO

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