23D0858790 CLIA NUMBER - GROSSE POINTE OB/GYN

Laboratory Demographics

CLIA Number: 23D0858790

Facility Name: GROSSE POINTE OB/GYN

Facility Address:
25910 KELLY ROAD SUITE I
ROSEVILLE, MI
ZIP 48066
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Facility Phone Number: 313 882-6780

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1396812624

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	23D0858790
LAB Type	Physician Office
Facility Name	GROSSE POINTE OB/GYN
Street	25910 KELLY ROAD SUITE I
City	ROSEVILLE
State	MI
ZIP	48066
Phone	313 882-6780
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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