23D0983650 CLIA NUMBER - MERCY PRIMARY CARE CENTER A CONTINUING MINISTRY OF TRINITY HEALTH

Laboratory Demographics

CLIA Number: 23D0983650

Facility Name: MERCY PRIMARY CARE CENTER A CONTINUING MINISTRY OF TRINITY HEALTH

Facility Address:
5555 CONNER AVENUE SUITE 2691
DETROIT, MI
ZIP 48213
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Facility Phone Number: 313 579-4000

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1275676066

Taxonomy: 3336C0002X - Pharmacy
A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.

CLIA Record

Field Name	Field Value
CLIA Number	23D0983650
LAB Type	Community Clinic
Facility Name	MERCY PRIMARY CARE CENTER A CONTINUING MINISTRY OF TRINITY HEALTH
Street	5555 CONNER AVENUE SUITE 2691
City	DETROIT
State	MI
ZIP	48213
Phone	313 579-4000
CertificateType	3
CertificateEffectiveDate	2/27/2023
CertificateExpirationDate	2/26/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024