23D0916007 CLIA NUMBER - LISA A MANZ DULAC, MD ASSOCIATES PC

Laboratory Demographics

  • CLIA Code: 23D0916007
  • Facility Name: LISA A MANZ DULAC, MD ASSOCIATES PC
  • Facility Address: 20030 MACK AVENUE
    GROSSE POINTE WOODS, MI
    ZIP 48236
  • Facility Phone: 313 884-3380
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LISA MANZ DULAC
  • NPI Number: 1871552497
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 23D0916007
LAB Type Physician Office
Facility Name LISA A MANZ DULAC, MD ASSOCIATES PC
Street 20030 MACK AVENUE
City GROSSE POINTE WOODS
State MI
ZIP 48236
Phone 313 884-3380
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/12/2024
Certificate Expiration Date 6/11/2026
Facility Type Physician Office
Lab Director LISA MANZ DULAC

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