23D1064376 CLIA NUMBER - HEARTFELT PHYSICIAN SERVICES

Laboratory Demographics

  • CLIA Code: 23D1064376
  • Facility Name: HEARTFELT PHYSICIAN SERVICES
  • Facility Address: 20245 W 12 MILE ROAD SUITE 120
    SOUTHFIELD, MI
    ZIP 48076
  • Facility Phone: 248 552-1327
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: REBECCA K. MOTLEY
  • NPI Number: 1578505129
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 23D1064376
LAB Type Physician Office
Facility Name HEARTFELT PHYSICIAN SERVICES
Street 20245 W 12 MILE ROAD SUITE 120
City SOUTHFIELD
State MI
ZIP 48076
Phone 248 552-1327
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2025
Certificate Expiration Date 2/4/2027
Facility Type Physician Office
Lab Director REBECCA K. MOTLEY

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