23D2021000 CLIA NUMBER - HAMTRAMCK PEDIATRICS

Laboratory Demographics

  • CLIA Code: 23D2021000
  • Facility Name: HAMTRAMCK PEDIATRICS
  • Facility Address: 11402 JOSEPH CAMPAU
    HAMTRAMCK, MI
    ZIP 48212
  • Facility Phone: 313 366-4000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MONIRUZZAMAN KHAN
  • NPI Number: 1033408935
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2021000
LAB Type Physician Office
Facility Name HAMTRAMCK PEDIATRICS
Street 11402 JOSEPH CAMPAU
City HAMTRAMCK
State MI
ZIP 48212
Phone 313 366-4000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2025
Certificate Expiration Date 3/2/2027
Facility Type Physician Office
Lab Director MONIRUZZAMAN KHAN

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