23D0962982 CLIA NUMBER - VINCENT R C MARIBAO MD PC

Laboratory Demographics

  • CLIA Code: 23D0962982
  • Facility Name: VINCENT R C MARIBAO MD PC
  • Facility Address: 29167 JEFFERSON AVENUE SUITE 100
    ST CLAIR SHORES, MI
    ZIP 48081
  • Facility Phone: (586) 498-1160
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VINCENT R C MARIBAO
  • NPI Number: 1730114760
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D0962982
LAB Type Physician Office
Facility Name VINCENT R C MARIBAO MD PC
Street 29167 JEFFERSON AVENUE SUITE 100
City ST CLAIR SHORES
State MI
ZIP 48081
Phone 5864981160
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/30/2025
Certificate Expiration Date 11/29/2027
Facility Type Physician Office
Lab Director VINCENT R C MARIBAO

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This page was last updated on: 6/29/2026