23D2287523 CLIA NUMBER - MICHIGAN COMPASSIONATE CARE AND EASTERN CARE

Laboratory Demographics

CLIA Number: 23D2287523

Facility Name: MICHIGAN COMPASSIONATE CARE AND EASTERN CARE

Facility Address:
28401 HOOVER ROAD
WARREN, MI
ZIP 48093
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Facility Phone Number: 313 573-5814

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1316939952

Taxonomy: 2085R0202X - Radiology
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

CLIA Record

Field Name	Field Value
CLIA Number	23D2287523
LAB Type	Physician Office
Facility Name	MICHIGAN COMPASSIONATE CARE AND EASTERN CARE
Street	28401 HOOVER ROAD
City	WARREN
State	MI
ZIP	48093
Phone	313 573-5814
CertificateType	4
CertificateEffectiveDate	8/15/2023
CertificateExpirationDate	8/14/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024