23D1021010 CLIA NUMBER - INTERNAL MEDICINE ASSOCIATES OF SOUTH EAST MI

Laboratory Demographics

CLIA Number: 23D1021010

Facility Name: INTERNAL MEDICINE ASSOCIATES OF SOUTH EAST MI

Facility Address:
5429 WHITTAKER
YPSILANTI, MI
ZIP 48197
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Facility Phone Number: 734 480-1400

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1679663264

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	23D1021010
LAB Type	Physician Office
Facility Name	INTERNAL MEDICINE ASSOCIATES OF SOUTH EAST MI
Street	5429 WHITTAKER
City	YPSILANTI
State	MI
ZIP	48197
Phone	734 480-1400
CertificateType	4
CertificateEffectiveDate	1/9/2024
CertificateExpirationDate	1/8/2026
FacilityType	Waiver

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