23D2283106 CLIA NUMBER - MEDICINA SCARLETT, LLC

Laboratory Demographics

  • CLIA Code: 23D2283106
  • Facility Name: MEDICINA SCARLETT, LLC
  • Facility Address: 8631 W VERNOR HIGHWAY SUITE 1A
    DETROIT, MI
    ZIP 48209
  • Facility Phone: 917 885-5670
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: SCARLETT IDEMA
  • NPI Number: 1912602285
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2283106
LAB Type Community Clinic
Facility Name MEDICINA SCARLETT, LLC
Street 8631 W VERNOR HIGHWAY SUITE 1A
City DETROIT
State MI
ZIP 48209
Phone 917 885-5670
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Community Clinic
Lab Director SCARLETT IDEMA

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