23D2078996 CLIA NUMBER - HENRY FORD HOSPITAL - WEST BLOOMFIELD

Laboratory Demographics

  • CLIA Code: 23D2078996
  • Facility Name: HENRY FORD HOSPITAL - WEST BLOOMFIELD
  • Facility Address: 6777 W MAPLE ROAD 2ND FLOOR EAST ROOM 2040
    WEST BLOOMFIELD, MI
    ZIP 48322
  • Facility Phone: 313 916-1102
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: BISENA BULICA
  • NPI Number: 1790170777
  • Taxonomy: 261QC1500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2078996
LAB Type Ancillary Testing Site in Health Care Center
Facility Name HENRY FORD HOSPITAL - WEST BLOOMFIELD
Street 6777 W MAPLE ROAD 2ND FLOOR EAST ROOM 2040
City WEST BLOOMFIELD
State MI
ZIP 48322
Phone 313 916-1102
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2024
Certificate Expiration Date 6/8/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director BISENA BULICA

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