23D2316445 CLIA NUMBER - AEGIS MEDICAL

Laboratory Demographics

  • CLIA Code: 23D2316445
  • Facility Name: AEGIS MEDICAL
  • Facility Address: 17888 MACK AVENUE
    GROSSE POINTE, MI
    ZIP 48230
  • Facility Phone: 888 849-1080
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PETER J. FARAGO
  • NPI Number: 1831883529
  • Taxonomy: 207QA0401X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2316445
LAB Type Physician Office
Facility Name AEGIS MEDICAL
Street 17888 MACK AVENUE
City GROSSE POINTE
State MI
ZIP 48230
Phone 888 849-1080
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2025
Certificate Expiration Date 1/5/2027
Facility Type Physician Office
Lab Director PETER J. FARAGO

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