23D2083513 CLIA NUMBER - THERAPEUTICS

Laboratory Demographics

  • CLIA Code: 23D2083513
  • Facility Name: THERAPEUTICS
  • Facility Address: 1010 E WEST MAPLE ROAD SUITE 200
    WALLED LAKE, MI
    ZIP 48390
  • Facility Phone: 248 525-6832
  • Facility Type: Other - OUTPATIENT MEDTHADONE
  • Facility Type: Waiver
  • Lab Director: DEIDRE V. GOLDSMITH
  • NPI Number: 1902284193
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2083513
LAB Type Other - OUTPATIENT MEDTHADONE
Facility Name THERAPEUTICS
Street 1010 E WEST MAPLE ROAD SUITE 200
City WALLED LAKE
State MI
ZIP 48390
Phone 248 525-6832
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2024
Certificate Expiration Date 9/7/2026
Facility Type Other - OUTPATIENT MEDTHADONE
Lab Director DEIDRE V. GOLDSMITH

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