23D0920994 CLIA NUMBER - PAVILION FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 23D0920994
  • Facility Name: PAVILION FAMILY PRACTICE
  • Facility Address: 23077 GREENFIELD RD SUITE 195
    SOUTHFIELD, MI
    ZIP 48075
  • Facility Phone: 248 423-0700
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: STANLEY K. SAUNDERS MD
  • NPI Number: 1346432184
  • Taxonomy: 302F00000X - Exclusive Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 23D0920994
LAB Type Physician Office
Facility Name PAVILION FAMILY PRACTICE
Street 23077 GREENFIELD RD SUITE 195
City SOUTHFIELD
State MI
ZIP 48075
Phone 248 423-0700
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 8/7/2024
Certificate Expiration Date 8/6/2026
Facility Type Physician Office
Lab Director STANLEY K. SAUNDERS MD

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