23D0725304 CLIA NUMBER - MICHIGAN HEALTHCARE PROFESSIONAL, PC

Laboratory Demographics

CLIA Number: 23D0725304

Facility Name: MICHIGAN HEALTHCARE PROFESSIONAL, PC

Facility Address:
13860 CANAL ROAD SUITE 100
STERLING HEIGHTS, MI
ZIP 48313
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Facility Phone Number: 586 558-3000

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1538597877

Taxonomy: 261QP3300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D0725304
LAB Type	Physician Office
Facility Name	MICHIGAN HEALTHCARE PROFESSIONAL, PC
Street	13860 CANAL ROAD SUITE 100
City	STERLING HEIGHTS
State	MI
ZIP	48313
Phone	586 558-3000
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024