23D0919235 CLIA NUMBER - HENRY FORD HEALTH INTERNAL MEDICINE - DEARBORN

Laboratory Demographics

  • CLIA Code: 23D0919235
  • Facility Name: HENRY FORD HEALTH INTERNAL MEDICINE - DEARBORN
  • Facility Address: 23874 KEAN STREET SUITE 100
    DEARBORN, MI
    ZIP 48124
  • Facility Phone: 313 359-0801
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MANISHA S. GARG
  • NPI Number: 1366219651
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D0919235
LAB Type Physician Office
Facility Name HENRY FORD HEALTH INTERNAL MEDICINE - DEARBORN
Street 23874 KEAN STREET SUITE 100
City DEARBORN
State MI
ZIP 48124
Phone 313 359-0801
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2024
Certificate Expiration Date 6/20/2026
Facility Type Physician Office
Lab Director MANISHA S. GARG

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