23D1036028 CLIA NUMBER - PHYSICIAN HEALTHCARE NETWORK

Laboratory Demographics

  • CLIA Code: 23D1036028
  • Facility Name: PHYSICIAN HEALTHCARE NETWORK
  • Facility Address: 36267 26 MILE ROAD SUITE 3
    LENOX, MI
    ZIP 48048
  • Facility Phone: 586 716-1371
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PIETRO O. CAVATAIO
  • NPI Number: 1295941375
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D1036028
LAB Type Physician Office
Facility Name PHYSICIAN HEALTHCARE NETWORK
Street 36267 26 MILE ROAD SUITE 3
City LENOX
State MI
ZIP 48048
Phone 586 716-1371
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2025
Certificate Expiration Date 1/18/2027
Facility Type Physician Office
Lab Director PIETRO O. CAVATAIO

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