23D2179169 CLIA NUMBER - INTERSTATE HOME HEALTH LLC

Laboratory Demographics

  • CLIA Code: 23D2179169
  • Facility Name: INTERSTATE HOME HEALTH LLC
  • Facility Address: 27177 LAHSER ROAD SUITE 102
    SOUTHFIELD, MI
    ZIP 48034
  • Facility Phone: 248 809-2500
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: IRENE M. MENDYUK
  • NPI Number: 1114571692
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 23D2179169
LAB Type Home Health Agency
Facility Name INTERSTATE HOME HEALTH LLC
Street 27177 LAHSER ROAD SUITE 102
City SOUTHFIELD
State MI
ZIP 48034
Phone 248 809-2500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/18/2024
Certificate Expiration Date 2/17/2026
Facility Type Home Health Agency
Lab Director IRENE M. MENDYUK

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