23D2061944 CLIA NUMBER - MARINERS INN

Laboratory Demographics

CLIA Code: 23D2061944
Facility Name: MARINERS INN
Facility Address: 445 - 457 LEDYARD
DETROIT, MI
ZIP 48201
Facility Phone: 313 962-9446
Facility Type: Other - SUD OUTPATENT
Facility Type: Waiver
Lab Director: BRITTANY D. MILES
NPI Number: 1558485466
Taxonomy: 320800000X - Community Based Residential Treatment Facility, Mental Illness

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CLIA Record

Field Name	Field Value
CLIA Number	23D2061944
LAB Type	Other - SUD OUTPATENT
Facility Name	MARINERS INN
Street	445 - 457 LEDYARD
City	DETROIT
State	MI
ZIP	48201
Phone	313 962-9446
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	2/10/2025
Certificate Expiration Date	2/9/2027
Facility Type	Other - SUD OUTPATENT
Lab Director	BRITTANY D. MILES

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