23D2051736 CLIA NUMBER - CUSTOM HOSPICE, LLC

Laboratory Demographics

  • CLIA Code: 23D2051736
  • Facility Name: CUSTOM HOSPICE, LLC
  • Facility Address: 888 W BIG BEAVER ROAD SUITE 900
    TROY, MI
    ZIP 48084
  • Facility Phone: 248 582-7400
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: CYNTHIA FRAZIER
  • NPI Number: 1558613281
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 23D2051736
LAB Type Hospice
Facility Name CUSTOM HOSPICE, LLC
Street 888 W BIG BEAVER ROAD SUITE 900
City TROY
State MI
ZIP 48084
Phone 248 582-7400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/27/2024
Certificate Expiration Date 12/26/2026
Facility Type Hospice
Lab Director CYNTHIA FRAZIER

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