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23D2157067 CLIA NUMBER - TRINITY HEALTH IHA MEDICAL GROUP PRIMARY CARE SOUTH LYON

Laboratory Demographics

CLIA Number: 23D2157067

Facility Name: TRINITY HEALTH IHA MEDICAL GROUP PRIMARY CARE SOUTH LYON

Facility Address:
23200 PONTIAC TRAIL
SOUTH LYON, MI
ZIP 48178
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Facility Phone Number: 248 446-2935

Facility Type: Physician Office

Certificate Type: Microscopy
NPI Number: 1669955894

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name Field Value
CLIA Number 23D2157067
LAB Type Physician Office
Facility Name TRINITY HEALTH IHA MEDICAL GROUP PRIMARY CARE SOUTH LYON
Street 23200 PONTIAC TRAIL
City SOUTH LYON
State MI
ZIP 48178
Phone 248 446-2935
CertificateType 3
CertificateEffectiveDate 10/30/2022
CertificateExpirationDate 10/29/2024
FacilityType PPMP

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This page was last updated on: 4/23/2024