23D2311516 CLIA NUMBER - HALO PRIMARY CARE PLLC

Laboratory Demographics

  • CLIA Code: 23D2311516
  • Facility Name: HALO PRIMARY CARE PLLC
  • Facility Address: 1535 E STATE FAIR AVENUE
    DETROIT, MI
    ZIP 48203
  • Facility Phone: 313 891-2740
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RIBHI HAZIN
  • NPI Number: 1750787784
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2311516
LAB Type Physician Office
Facility Name HALO PRIMARY CARE PLLC
Street 1535 E STATE FAIR AVENUE
City DETROIT
State MI
ZIP 48203
Phone 313 891-2740
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/24/2024
Certificate Expiration Date 9/23/2026
Facility Type Physician Office
Lab Director RIBHI HAZIN

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