23D2138847 CLIA NUMBER - HENRY FORD PROVIDENCE NOVI

Laboratory Demographics

  • CLIA Code: 23D2138847
  • Facility Name: HENRY FORD PROVIDENCE NOVI
  • Facility Address: 47601 GRAND RIVER
    NOVI, MI
    ZIP 48374
  • Facility Phone: 248 465-4289
  • Facility Type: Hospital
  • Facility Type: Waiver
  • Lab Director: EDSA M. NEGUSSIE
  • NPI Number: 1417196015
  • Taxonomy: 282N00000X - General Acute Care Hospital

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CLIA Record

Field Name Field Value
CLIA Number 23D2138847
LAB Type Hospital
Facility Name HENRY FORD PROVIDENCE NOVI
Street 47601 GRAND RIVER
City NOVI
State MI
ZIP 48374
Phone 248 465-4289
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2023
Certificate Expiration Date 10/24/2025
Facility Type Hospital
Lab Director EDSA M. NEGUSSIE

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