23D1075269 CLIA NUMBER - MAPLECREST MEDICAL

Laboratory Demographics

  • CLIA Code: 23D1075269
  • Facility Name: MAPLECREST MEDICAL
  • Facility Address: 35450 DEQUINDRE SUITE 103
    STERLING HEIGHTS, MI
    ZIP 48310
  • Facility Phone: 586 795-2980
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: GHAZAWAN K. KASHAT
  • NPI Number: 1477783702
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D1075269
LAB Type Physician Office
Facility Name MAPLECREST MEDICAL
Street 35450 DEQUINDRE SUITE 103
City STERLING HEIGHTS
State MI
ZIP 48310
Phone 586 795-2980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2025
Certificate Expiration Date 10/16/2027
Facility Type Physician Office
Lab Director GHAZAWAN K. KASHAT

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