23D2110719 CLIA NUMBER - DETROIT HEALTH DEPARTMENT - WIC

Laboratory Demographics

  • CLIA Code: 23D2110719
  • Facility Name: DETROIT HEALTH DEPARTMENT - WIC
  • Facility Address: 5555 CONNER - FORD WELLNESS BUILDING
    DETROIT, MI
    ZIP 48213
  • Facility Phone: 313 269-9561
  • Facility Type: Public Health Laboratories
  • Facility Type: Waiver
  • Lab Director: DENISE FAIR RAZO
  • NPI Number: 1841473568
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 23D2110719
LAB Type Public Health Laboratories
Facility Name DETROIT HEALTH DEPARTMENT - WIC
Street 5555 CONNER - FORD WELLNESS BUILDING
City DETROIT
State MI
ZIP 48213
Phone 313 269-9561
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Public Health Laboratories
Lab Director DENISE FAIR RAZO

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