Detroit Bio Medical Laboratories,Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

002174 Issued in MI

Legal business name

DETROIT BIO MEDICAL LABORATORIES,INC

Practice address

601 Bridge St
East Jordan, MI 49727-9383

Phone

(234) 536-7599

Fax

(248) 471-2340

NPI assigned

Apr 24, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Raymond P Zakaria, MS

Title

Manager

Phone

(248) 471-4111

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083832836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23955 FREEWAY PARK DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483352817",
            "telephone_number": "247-471-4111",
            "fax_number": "248-471-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BRIDGE ST",
            "city": "EAST JORDAN",
            "state": "MI",
            "postal_code": "497279383",
            "telephone_number": "234-536-7599",
            "fax_number": "248-471-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETROIT BIO MEDICAL LABORATORIES,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZAKARIA",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "248-471-4111",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "002174",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3118292",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adolph Cwik, MA, CRC, CCM, LBSW,
• Daniel J Thomas DC (Lakeside Chiropractic)
• Delicate Doula Services LLC
• Amy Lynn Depinto, NP
• William Robert Desjardins III, D.D.S.
• Larry C Dittmar
• Joseph Peter Doyle III
• Samuel G Dyste, P.A.
• East Jordan Family Health Center
• East Jordan Family Health Center (East Jordan Family Pharmacy)

• Clinical Medical Laboratory in East Jordan, MI
• Providers in East Jordan, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.