23D2187631 CLIA NUMBER - DEXTER DENTAL STUDIO

Laboratory Demographics

CLIA Number: 23D2187631

Facility Name: DEXTER DENTAL STUDIO

Facility Address:
7300 DEXTER ANN ARBOR ROAD SUITE 300
DEXTER, MI
ZIP 48130
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Facility Phone Number: 734 426-8360

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1053704817

Taxonomy: 261QD0000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D2187631
LAB Type	Physician Office
Facility Name	DEXTER DENTAL STUDIO
Street	7300 DEXTER ANN ARBOR ROAD SUITE 300
City	DEXTER
State	MI
ZIP	48130
Phone	734 426-8360
CertificateType	4
CertificateEffectiveDate	7/6/2022
CertificateExpirationDate	7/5/2024
FacilityType	Waiver

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