23D2278695 CLIA NUMBER - HAZEL PARK PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 23D2278695
  • Facility Name: HAZEL PARK PRIMARY CARE
  • Facility Address: 624 E 9 MILE ROAD SUITE B
    HAZEL PARK, MI
    ZIP 48030
  • Facility Phone: 248 629-7497
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MOHAMMED G. SALEH
  • NPI Number: 1306407440
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2278695
LAB Type Physician Office
Facility Name HAZEL PARK PRIMARY CARE
Street 624 E 9 MILE ROAD SUITE B
City HAZEL PARK
State MI
ZIP 48030
Phone 248 629-7497
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 Physician Office
Lab Director MOHAMMED G. SALEH

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