23D0906373 CLIA NUMBER - HENRY FORD MATERNAL FETAL MEDICINE SOUTHFIELD

Laboratory Demographics

  • CLIA Code: 23D0906373
  • Facility Name: HENRY FORD MATERNAL FETAL MEDICINE SOUTHFIELD
  • Facility Address: 22255 PROVIDENCE DRIVE SUITE 100
    SOUTHFIELD, MI
    ZIP 48075
  • Facility Phone: 248 849-2710
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ADHAM K. ALSAMSAM
  • NPI Number: 1780830943
  • Taxonomy: 332BX2000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 23D0906373
LAB Type Physician Office
Facility Name HENRY FORD MATERNAL FETAL MEDICINE SOUTHFIELD
Street 22255 PROVIDENCE DRIVE SUITE 100
City SOUTHFIELD
State MI
ZIP 48075
Phone 248 849-2710
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/8/2024
Certificate Expiration Date 2/7/2026
Facility Type Physician Office
Lab Director ADHAM K. ALSAMSAM

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