23D2115923 CLIA NUMBER - PREMIER PRIVATE PHYSICIANS

Laboratory Demographics

  • CLIA Code: 23D2115923
  • Facility Name: PREMIER PRIVATE PHYSICIANS
  • Facility Address: 1627 W BIG BEAVER ROAD
    TROY, MI
    ZIP 48084
  • Facility Phone: 248 220-1560
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KEITH W. CHRISTMON
  • NPI Number: 1134765811
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2115923
LAB Type Physician Office
Facility Name PREMIER PRIVATE PHYSICIANS
Street 1627 W BIG BEAVER ROAD
City TROY
State MI
ZIP 48084
Phone 248 220-1560
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2024
Certificate Expiration Date 7/14/2026
Facility Type Physician Office
Lab Director KEITH W. CHRISTMON

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This page was last updated on: 6/4/2025