23D2061609 CLIA NUMBER - COREWELL HEALTH BEAUMONT TR HOSP CHILD PED SPE CTR - 44199 DEQUINDRE

Laboratory Demographics

  • CLIA Code: 23D2061609
  • Facility Name: COREWELL HEALTH BEAUMONT TR HOSP CHILD PED SPE CTR - 44199 DEQUINDRE
  • Facility Address: 44199 DEQUINDRE ROAD SUITE 615
    TROY, MI
    ZIP 48085
  • Facility Phone: 248 964-9660
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOUHIB AYAS
  • NPI Number: 1043549439
  • Taxonomy: 3336I0012X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2061609
LAB Type Physician Office
Facility Name COREWELL HEALTH BEAUMONT TR HOSP CHILD PED SPE CTR - 44199 DEQUINDRE
Street 44199 DEQUINDRE ROAD SUITE 615
City TROY
State MI
ZIP 48085
Phone 248 964-9660
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2025
Certificate Expiration Date 7/1/2027
Facility Type Physician Office
Lab Director MOUHIB AYAS

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