23D1063289 CLIA NUMBER - I & L PROFESSIONAL MEDICAL SERVICES PC

Laboratory Demographics

  • CLIA Code: 23D1063289
  • Facility Name: I & L PROFESSIONAL MEDICAL SERVICES PC
  • Facility Address: 15357 FARMINGTON ROAD SUITE 2
    LIVONIA, MI
    ZIP 48154
  • Facility Phone: 734 266-3565
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: INNOCENT E. AGBASSI
  • NPI Number: 1760409593
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D1063289
LAB Type Physician Office
Facility Name I & L PROFESSIONAL MEDICAL SERVICES PC
Street 15357 FARMINGTON ROAD SUITE 2
City LIVONIA
State MI
ZIP 48154
Phone 734 266-3565
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Physician Office
Lab Director INNOCENT E. AGBASSI

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