23D2295066 CLIA NUMBER - CENTRAL CITY HEALTH

Laboratory Demographics

CLIA Number: 23D2295066

Facility Name: CENTRAL CITY HEALTH

Facility Address:
1240 3RD AVENUE
DETROIT, MI
ZIP 48226
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Facility Phone Number: 313 831-3160

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1285043406

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D2295066
LAB Type	Federally Qualified Health Center
Facility Name	CENTRAL CITY HEALTH
Street	1240 3RD AVENUE
City	DETROIT
State	MI
ZIP	48226
Phone	313 831-3160
CertificateType	4
CertificateEffectiveDate	12/5/2023
CertificateExpirationDate	12/4/2025
FacilityType	Waiver

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