23D2023045 CLIA NUMBER - BASHA DIAGNOSTICS

Laboratory Demographics

  • CLIA Code: 23D2023045
  • Facility Name: BASHA DIAGNOSTICS
  • Facility Address: 30701 WOODWARD AVENUE SUITE LL
    ROYAL OAK, MI
    ZIP 48073
  • Facility Phone: 586 566-8680
  • Facility Type: Other - OUTPATIENT DX RADIO CNTR
  • Facility Type: Waiver
  • Lab Director: JACQUELINE A. ARNOLD
  • NPI Number: 1770693798
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 23D2023045
LAB Type Other - OUTPATIENT DX RADIO CNTR
Facility Name BASHA DIAGNOSTICS
Street 30701 WOODWARD AVENUE SUITE LL
City ROYAL OAK
State MI
ZIP 48073
Phone 586 566-8680
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Other - OUTPATIENT DX RADIO CNTR
Lab Director JACQUELINE A. ARNOLD

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