23D0923936 CLIA NUMBER - SARVESWARARAO TALLA MD

Laboratory Demographics

  • CLIA Code: 23D0923936
  • Facility Name: SARVESWARARAO TALLA MD
  • Facility Address: 17356 W 12 MILE RD SUITE 100
    SOUTHFIELD, MI
    ZIP 48076
  • Facility Phone: 248 552-1220
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SARVESWARARAO TALLA
  • NPI Number: 1932126752
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 23D0923936
LAB Type Physician Office
Facility Name SARVESWARARAO TALLA MD
Street 17356 W 12 MILE RD SUITE 100
City SOUTHFIELD
State MI
ZIP 48076
Phone 248 552-1220
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2024
Certificate Expiration Date 5/2/2026
Facility Type Physician Office
Lab Director SARVESWARARAO TALLA

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