23D0929767 CLIA NUMBER - QUALICARE NURSING HOME

Laboratory Demographics

  • CLIA Code: 23D0929767
  • Facility Name: QUALICARE NURSING HOME
  • Facility Address: 695 EAST GRAND BOULEVARD
    DETROIT, MI
    ZIP 48207
  • Facility Phone: 313 925-6655
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: VINCENT E. VILLANUEVA
  • NPI Number: 1700883030
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 23D0929767
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name QUALICARE NURSING HOME
Street 695 EAST GRAND BOULEVARD
City DETROIT
State MI
ZIP 48207
Phone 313 925-6655
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 Skilled Nursing Facility/Nursing Facility
Lab Director VINCENT E. VILLANUEVA

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