23D2278672 CLIA NUMBER - AXIOM HOSPICE LLC

Laboratory Demographics

  • CLIA Code: 23D2278672
  • Facility Name: AXIOM HOSPICE LLC
  • Facility Address: 12815 NORTHLINE ROAD
    SOUTHGATE, MI
    ZIP 48195
  • Facility Phone: (734) 324-3166
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: IMRAN KHAN
  • NPI Number: 1659085744
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 23D2278672
LAB Type Hospice
Facility Name AXIOM HOSPICE LLC
Street 12815 NORTHLINE ROAD
City SOUTHGATE
State MI
ZIP 48195
Phone 7343243166
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Hospice
Lab Director IMRAN KHAN

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This page was last updated on: 5/15/2026