23D0998948 CLIA NUMBER - ST JOHN ENDOCRINOLOGY

Laboratory Demographics

  • CLIA Code: 23D0998948
  • Facility Name: ST JOHN ENDOCRINOLOGY
  • Facility Address: 20229 E 9 MILE ROAD SUITE 200
    ST CLAIR SHORES, MI
    ZIP 48080
  • Facility Phone: 586 267-0200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHERILYN J. RUSSELL
  • NPI Number: 1215067046
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D0998948
LAB Type Physician Office
Facility Name ST JOHN ENDOCRINOLOGY
Street 20229 E 9 MILE ROAD SUITE 200
City ST CLAIR SHORES
State MI
ZIP 48080
Phone 586 267-0200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/30/2024
Certificate Expiration Date 4/29/2026
Facility Type Physician Office
Lab Director SHERILYN J. RUSSELL

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