23D1036030 CLIA NUMBER - HENRY FORD WYANDOTTE NORTHLINE WOMEN'S HEALTH CENTER SOUTHGATE

Laboratory Demographics

  • CLIA Code: 23D1036030
  • Facility Name: HENRY FORD WYANDOTTE NORTHLINE WOMEN'S HEALTH CENTER SOUTHGATE
  • Facility Address: 15675 NORTHLINE ROAD
    SOUTHGATE, MI
    ZIP 48195
  • Facility Phone: 734 282-3600
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MUNTHER ALAIWAT
  • NPI Number: 1497996599
  • Taxonomy: 332H00000X - Eyewear Supplier

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CLIA Record

Field Name Field Value
CLIA Number 23D1036030
LAB Type Physician Office
Facility Name HENRY FORD WYANDOTTE NORTHLINE WOMEN'S HEALTH CENTER SOUTHGATE
Street 15675 NORTHLINE ROAD
City SOUTHGATE
State MI
ZIP 48195
Phone 734 282-3600
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 1/19/2025
Certificate Expiration Date 1/18/2027
Facility Type Physician Office
Lab Director MUNTHER ALAIWAT

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