23D2045052 CLIA NUMBER - ADVANCED DERMATOLOGY OF MICHIGAN

Laboratory Demographics

  • CLIA Code: 23D2045052
  • Facility Name: ADVANCED DERMATOLOGY OF MICHIGAN
  • Facility Address: 13450 E 12 MILE ROAD
    WARREN, MI
    ZIP 48088
  • Facility Phone: 407 284-3407
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: MICHAEL W. WHITWORTH
  • NPI Number: 1811231715
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 23D2045052
LAB Type Physician Office
Facility Name ADVANCED DERMATOLOGY OF MICHIGAN
Street 13450 E 12 MILE ROAD
City WARREN
State MI
ZIP 48088
Phone 407 284-3407
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Physician Office
Lab Director MICHAEL W. WHITWORTH

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