23D2150172 CLIA NUMBER - THE WELLNESS PLAN MEDICAL CENTERS - GATEWAY

Laboratory Demographics

  • CLIA Code: 23D2150172
  • Facility Name: THE WELLNESS PLAN MEDICAL CENTERS - GATEWAY
  • Facility Address: 2888 W GRAND BLVD
    DETROIT, MI
    ZIP 48202
  • Facility Phone: 313 875-5026
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: TIFFANY L. SANFORD
  • NPI Number: 1447675434
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2150172
LAB Type Federally Qualified Health Center
Facility Name THE WELLNESS PLAN MEDICAL CENTERS - GATEWAY
Street 2888 W GRAND BLVD
City DETROIT
State MI
ZIP 48202
Phone 313 875-5026
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/19/2024
Certificate Expiration Date 6/18/2026
Facility Type Federally Qualified Health Center
Lab Director TIFFANY L. SANFORD

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