23D2054535 CLIA NUMBER - PRAVEEN MODI, MD, PC

Laboratory Demographics

  • CLIA Code: 23D2054535
  • Facility Name: PRAVEEN MODI, MD, PC
  • Facility Address: 9857 N HAGGERTY ROAD
    PLYMOUTH, MI
    ZIP 48170
  • Facility Phone: 734 680-8889
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PRAVEEN K. MODI
  • NPI Number: 1922345107
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2054535
LAB Type Physician Office
Facility Name PRAVEEN MODI, MD, PC
Street 9857 N HAGGERTY ROAD
City PLYMOUTH
State MI
ZIP 48170
Phone 734 680-8889
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/25/2025
Certificate Expiration Date 2/24/2027
Facility Type Physician Office
Lab Director PRAVEEN K. MODI

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