23D1018496 CLIA NUMBER - CHANGHEE KIM MD PHD PLC

Laboratory Demographics

  • CLIA Code: 23D1018496
  • Facility Name: CHANGHEE KIM MD PHD PLC
  • Facility Address: 38815 DEQUINDRE ROAD SUITE 103
    TROY, MI
    ZIP 48083
  • Facility Phone: 248 740-7771
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CHANGHEE KIM
  • NPI Number: 1215918479
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D1018496
LAB Type Physician Office
Facility Name CHANGHEE KIM MD PHD PLC
Street 38815 DEQUINDRE ROAD SUITE 103
City TROY
State MI
ZIP 48083
Phone 248 740-7771
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 10/24/2023
Certificate Expiration Date 10/23/2025
Facility Type Physician Office
Lab Director CHANGHEE KIM

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