23D2030163 CLIA NUMBER - SOUTHFIELD CITY URGENT CARE PC

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Laboratory Demographics

CLIA Number: 23D2030163

Facility Name: SOUTHFIELD CITY URGENT CARE PC

Facility Address:
23832 SOUTHFIELD ROAD
SOUTHFIELD, MI
ZIP 48075
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Facility Phone Number: 313 516-0763

Facility Type: Other - URGENT CARE

Certificate Type: Waiver

NPI Number: 1811278716

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D2030163
LAB Type	Other - URGENT CARE
Facility Name	SOUTHFIELD CITY URGENT CARE PC
Street	23832 SOUTHFIELD ROAD
City	SOUTHFIELD
State	MI
ZIP	48075
Phone	313 516-0763
CertificateType	4
CertificateEffectiveDate	9/22/2023
CertificateExpirationDate	9/21/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024