23D2306055 CLIA NUMBER - WEST DEARBORN PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 23D2306055
  • Facility Name: WEST DEARBORN PRIMARY CARE
  • Facility Address: 2421 MONROE STREET SUITE 103
    DEARBORN, MI
    ZIP 48124
  • Facility Phone: 313 447-0888
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALKHOURY GHATTAS
  • NPI Number: 1427787241
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2306055
LAB Type Physician Office
Facility Name WEST DEARBORN PRIMARY CARE
Street 2421 MONROE STREET SUITE 103
City DEARBORN
State MI
ZIP 48124
Phone 313 447-0888
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2024
Certificate Expiration Date 6/10/2026
Facility Type Physician Office
Lab Director ALKHOURY GHATTAS

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