23D1025590 CLIA NUMBER - MAPLE MANOR REHAB CENTER

Laboratory Demographics

  • CLIA Code: 23D1025590
  • Facility Name: MAPLE MANOR REHAB CENTER
  • Facility Address: 3999 VENOY ROAD
    WAYNE, MI
    ZIP 48184
  • Facility Phone: 734 727-0440
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STELLA S. EVANGELISTA
  • NPI Number: 1053306019
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 23D1025590
LAB Type Physician Office
Facility Name MAPLE MANOR REHAB CENTER
Street 3999 VENOY ROAD
City WAYNE
State MI
ZIP 48184
Phone 734 727-0440
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2024
Certificate Expiration Date 5/11/2026
Facility Type Physician Office
Lab Director STELLA S. EVANGELISTA

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