23D2223018 CLIA NUMBER - JACKSON URGENT CARE

Laboratory Demographics

  • CLIA Code: 23D2223018
  • Facility Name: JACKSON URGENT CARE
  • Facility Address: 1407 E MICHIGAN AVENUE
    JACKSON, MI
    ZIP 49202
  • Facility Phone: 313 377-5758
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IBRAHIM DABAJA
  • NPI Number: 1528643723
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2223018
LAB Type Physician Office
Facility Name JACKSON URGENT CARE
Street 1407 E MICHIGAN AVENUE
City JACKSON
State MI
ZIP 49202
Phone 313 377-5758
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Physician Office
Lab Director IBRAHIM DABAJA

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