36D1003983 CLIA NUMBER - IDA FAMILY WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 36D1003983
  • Facility Name: IDA FAMILY WELLNESS CENTER
  • Facility Address: 3160 LEWIS AVENUE
    IDA, MI
    ZIP 48140
  • Facility Phone: 734 322-5879
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LAYTH MADLOOD
  • NPI Number: 1831113414
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 36D1003983
LAB Type Physician Office
Facility Name IDA FAMILY WELLNESS CENTER
Street 3160 LEWIS AVENUE
City IDA
State MI
ZIP 48140
Phone 734 322-5879
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/9/2024
Certificate Expiration Date 6/8/2026
Facility Type Physician Office
Lab Director LAYTH MADLOOD

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