Detroit Bio Medical Laboratories,Inc
Organization Active NPI Clinical Medical Laboratory · White Cloud, MI
NPI 1104044957 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1104044957
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Medical Laboratory 291U00000X
- License
- 002174 (MI)
- Legal business name
- DETROIT BIO MEDICAL LABORATORIES,INC
- Practice address
- 1035 E Wilcox Ave
White Cloud, MI 49349-8794 - Phone
- (231) 689-1652
- Fax
- (248) 471-2340
- NPI assigned
- Apr 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Raymond P Zakaria, MS
- Title
- Manager
- Phone
- (248) 471-4111
Corporate family (same tax ID) 2
National Provider Directory
- Tax ID family
- Detroit Bio Medical Laboratoriesinc
Locations
126 S Benson St
White Cloud, MI 49349
Phone (231) 689-1608
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | 002174 | MI | Yes |
Addresses
Primary practice location
1035 E Wilcox Ave
White Cloud, MI 49349-8794
Mailing address
23955 Freeway Park Dr
Farmington Hills, MI 48335-2817
Phone (248) 471-4111
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3077879 | Medicaid | MI |
Other providers in White Cloud, MI
- Toni Dejohn
- Emily Elizabeth Derks
- Amy Marie Derus
- Heather Derwin
- Jennifer Derwin
- District Health Department #10
- District Health Department No 10
- District Health Department No 10
- Lisa R Dysard
- Riley Jean Eggers
All providers in White Cloud, MI · Clinical Medical Laboratory in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.