23D2205831 CLIA NUMBER - ONECARE LTC LLC

Laboratory Demographics

  • CLIA Code: 23D2205831
  • Facility Name: ONECARE LTC LLC
  • Facility Address: 1945 HEIDE DRIVE
    TROY, MI
    ZIP 48084
  • Facility Phone: 248 663-2273
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HANY BOUTROS
  • NPI Number: 1013394378
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 23D2205831
LAB Type Pharmacy
Facility Name ONECARE LTC LLC
Street 1945 HEIDE DRIVE
City TROY
State MI
ZIP 48084
Phone 248 663-2273
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2024
Certificate Expiration Date 12/15/2026
Facility Type Pharmacy
Lab Director HANY BOUTROS

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