23D2028349 CLIA NUMBER - VISTA MARIA

Laboratory Demographics

  • CLIA Code: 23D2028349
  • Facility Name: VISTA MARIA
  • Facility Address: 20651 W WARREN AVENUE
    DEARBORN HEIGHTS, MI
    ZIP 48127
  • Facility Phone: 313 271-3050
  • Facility Type: Other - TREATMENT FACILITY BEHAV
  • Facility Type: Waiver
  • Lab Director: ALICE M. MALINOWSKI
  • NPI Number: 1497928816
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 23D2028349
LAB Type Other - TREATMENT FACILITY BEHAV
Facility Name VISTA MARIA
Street 20651 W WARREN AVENUE
City DEARBORN HEIGHTS
State MI
ZIP 48127
Phone 313 271-3050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2025
Certificate Expiration Date 8/14/2027
Facility Type Other - TREATMENT FACILITY BEHAV
Lab Director ALICE M. MALINOWSKI

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