23D2160606 CLIA NUMBER - PREMIER PEDIATRICS

Laboratory Demographics

  • CLIA Code: 23D2160606
  • Facility Name: PREMIER PEDIATRICS
  • Facility Address: 22318 FORD ROAD
    DEARBORN HEIGHTS, MI
    ZIP 48127
  • Facility Phone: 313 278-2788
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MAZEN N. HAMAMEH
  • NPI Number: 1174970396
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 23D2160606
LAB Type Physician Office
Facility Name PREMIER PEDIATRICS
Street 22318 FORD ROAD
City DEARBORN HEIGHTS
State MI
ZIP 48127
Phone 313 278-2788
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/15/2025
Certificate Expiration Date 1/14/2027
Facility Type Physician Office
Lab Director MAZEN N. HAMAMEH

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