23D2110417 CLIA NUMBER - AMITY INTERNAL MEDICINE PC

Laboratory Demographics

  • CLIA Code: 23D2110417
  • Facility Name: AMITY INTERNAL MEDICINE PC
  • Facility Address: 31500 TELEGRAPH SUITE 240
    BINGHAM FARMS, MI
    ZIP 48025
  • Facility Phone: 248 792-3690
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KAREN RAQUEL RUSSELL-LITTLE
  • NPI Number: 1588031280
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2110417
LAB Type Physician Office
Facility Name AMITY INTERNAL MEDICINE PC
Street 31500 TELEGRAPH SUITE 240
City BINGHAM FARMS
State MI
ZIP 48025
Phone 248 792-3690
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Physician Office
Lab Director KAREN RAQUEL RUSSELL-LITTLE

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