23D2057250 CLIA NUMBER - TRINITY HEALTH IHA MEDICAL GROUP PRIMARY CARE SOUTHEAST LIVONIA

Laboratory Demographics

  • CLIA Code: 23D2057250
  • Facility Name: TRINITY HEALTH IHA MEDICAL GROUP PRIMARY CARE SOUTHEAST LIVONIA
  • Facility Address: 29370 PLYMOUTH ROAD SUITE 100
    LIVONIA, MI
    ZIP 48150
  • Facility Phone: 734 655-8200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERIN C. WALTON-DOYLE
  • NPI Number: 1972374221
  • Taxonomy: 343900000X - Non-emergency Medical Transport (VAN)

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CLIA Record

Field Name Field Value
CLIA Number 23D2057250
LAB Type Physician Office
Facility Name TRINITY HEALTH IHA MEDICAL GROUP PRIMARY CARE SOUTHEAST LIVONIA
Street 29370 PLYMOUTH ROAD SUITE 100
City LIVONIA
State MI
ZIP 48150
Phone 734 655-8200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2025
Certificate Expiration Date 7/7/2027
Facility Type Physician Office
Lab Director ERIN C. WALTON-DOYLE

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