23D2025608 CLIA NUMBER - EASTBORN MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 23D2025608
  • Facility Name: EASTBORN MEDICAL GROUP
  • Facility Address: 15044 MICHIGAN AVENUE
    DEARBORN, MI
    ZIP 48126
  • Facility Phone: 313 406-5007
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ASSEM ELFAKIH
  • NPI Number: 1306397989
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2025608
LAB Type Physician Office
Facility Name EASTBORN MEDICAL GROUP
Street 15044 MICHIGAN AVENUE
City DEARBORN
State MI
ZIP 48126
Phone 313 406-5007
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2025
Certificate Expiration Date 6/13/2027
Facility Type Physician Office
Lab Director ASSEM ELFAKIH

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