23D2060228 CLIA NUMBER - MAIN STREET PHYSICIANS PC

Laboratory Demographics

  • CLIA Code: 23D2060228
  • Facility Name: MAIN STREET PHYSICIANS PC
  • Facility Address: 25000 HALL ROAD, SUITE ONE
    WOODHAVEN, MI
    ZIP 48183
  • Facility Phone: 734 676-3373
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER R. DE ANGELIS
  • NPI Number: 1811171234
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2060228
LAB Type Physician Office
Facility Name MAIN STREET PHYSICIANS PC
Street 25000 HALL ROAD, SUITE ONE
City WOODHAVEN
State MI
ZIP 48183
Phone 734 676-3373
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2025
Certificate Expiration Date 6/9/2027
Facility Type Physician Office
Lab Director CHRISTOPHER R. DE ANGELIS

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