23D2155592 CLIA NUMBER - PELHAM PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 23D2155592
  • Facility Name: PELHAM PRIMARY CARE
  • Facility Address: 3815 PELHAM STREET SUITE 7
    DEARBORN, MI
    ZIP 48124
  • Facility Phone: 313 789-7635
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TALAL KHADER
  • NPI Number: 1336665728
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2155592
LAB Type Physician Office
Facility Name PELHAM PRIMARY CARE
Street 3815 PELHAM STREET SUITE 7
City DEARBORN
State MI
ZIP 48124
Phone 313 789-7635
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Physician Office
Lab Director TALAL KHADER

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