23D1002150 CLIA NUMBER - EASTSIDE INTERNAL MEDICINE, PC

Laboratory Demographics

  • CLIA Code: 23D1002150
  • Facility Name: EASTSIDE INTERNAL MEDICINE, PC
  • Facility Address: 28315 HARPER
    ST CLAIR SHORES, MI
    ZIP 48081
  • Facility Phone: 586 552-1710
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEPHEN P. D ADDARIO
  • NPI Number: 1831201821
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D1002150
LAB Type Physician Office
Facility Name EASTSIDE INTERNAL MEDICINE, PC
Street 28315 HARPER
City ST CLAIR SHORES
State MI
ZIP 48081
Phone 586 552-1710
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2024
Certificate Expiration Date 7/29/2026
Facility Type Physician Office
Lab Director STEPHEN P. D ADDARIO

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