23D1049487 CLIA NUMBER - BEHAVIORAL CENTER OF MICHIGAN, THE

Laboratory Demographics

  • CLIA Code: 23D1049487
  • Facility Name: BEHAVIORAL CENTER OF MICHIGAN, THE
  • Facility Address: 4050 E 12 MILE ROAD
    WARREN, MI
    ZIP 48092
  • Facility Phone: 586 261-2266
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: LAUREN IANNOTTI
  • NPI Number: 1073072526
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 23D1049487
LAB Type Hospital
Facility Name BEHAVIORAL CENTER OF MICHIGAN, THE
Street 4050 E 12 MILE ROAD
City WARREN
State MI
ZIP 48092
Phone 586 261-2266
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2024
Certificate Expiration Date 1/8/2026
Facility Type Hospital
Lab Director LAUREN IANNOTTI

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