23D0857024 CLIA NUMBER - CLARKSTON INTERNAL MEDICINE PC

Laboratory Demographics

  • CLIA Code: 23D0857024
  • Facility Name: CLARKSTON INTERNAL MEDICINE PC
  • Facility Address: 7188 N MAIN STREET
    CLARKSTON, MI
    ZIP 48346
  • Facility Phone: 248 625-1600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NATHAN B. CHASE
  • NPI Number: 1417085085
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D0857024
LAB Type Physician Office
Facility Name CLARKSTON INTERNAL MEDICINE PC
Street 7188 N MAIN STREET
City CLARKSTON
State MI
ZIP 48346
Phone 248 625-1600
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 NATHAN B. CHASE

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