23D2264487 CLIA NUMBER - PRIME HOSPICE & SERVICES LLC

Laboratory Demographics

  • CLIA Code: 23D2264487
  • Facility Name: PRIME HOSPICE & SERVICES LLC
  • Facility Address: 17515 W 9 MILE ROAD SUITE 195
    SOUTHFIELD, MI
    ZIP 48075
  • Facility Phone: 248 796-7204
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHAEL T. LOPEZ
  • NPI Number: 1497407084
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 23D2264487
LAB Type Physician Office
Facility Name PRIME HOSPICE & SERVICES LLC
Street 17515 W 9 MILE ROAD SUITE 195
City SOUTHFIELD
State MI
ZIP 48075
Phone 248 796-7204
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2024
Certificate Expiration Date 7/13/2026
Facility Type Physician Office
Lab Director MICHAEL T. LOPEZ

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