23D1011098 CLIA NUMBER - WALNUT LAKE OB/GYN

Laboratory Demographics

  • CLIA Code: 23D1011098
  • Facility Name: WALNUT LAKE OB/GYN
  • Facility Address: 2300 HAGGERTY ROAD SUITE 2070
    WEST BLOOMFIELD, MI
    ZIP 48323
  • Facility Phone: 248 926-2020
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LON E. KATZ
  • NPI Number: 1942340187
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 23D1011098
LAB Type Physician Office
Facility Name WALNUT LAKE OB/GYN
Street 2300 HAGGERTY ROAD SUITE 2070
City WEST BLOOMFIELD
State MI
ZIP 48323
Phone 248 926-2020
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Physician Office
Lab Director LON E. KATZ

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