23D2317522 CLIA NUMBER - VISITING WOUND SPECIALISTS & PRIMARY CARE PLLC

Laboratory Demographics

  • CLIA Code: 23D2317522
  • Facility Name: VISITING WOUND SPECIALISTS & PRIMARY CARE PLLC
  • Facility Address: 39880 VAN DYKE AVENUE SUITE 202
    STERLING HEIGHTS, MI
    ZIP 48313
  • Facility Phone: 248 376-9797
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DWIGHT ENCINAS
  • NPI Number: 1760268940
  • Taxonomy: 363L00000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 23D2317522
LAB Type Physician Office
Facility Name VISITING WOUND SPECIALISTS & PRIMARY CARE PLLC
Street 39880 VAN DYKE AVENUE SUITE 202
City STERLING HEIGHTS
State MI
ZIP 48313
Phone 248 376-9797
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2025
Certificate Expiration Date 1/26/2027
Facility Type Physician Office
Lab Director DWIGHT ENCINAS

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This page was last updated on: 6/4/2025