DMC Clinical Lab Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

039079 Issued in MI

Legal business name

DMC CLINICAL LAB INC

Practice address

2888 W Grand Blvd
Detroit, MI 48202-2612

Phone

(313) 871-1200

Fax

(313) 871-1212

NPI assigned

Aug 30, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Elizabeth Asfaw

Title

Owner

Phone

(313) 871-1200

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124137179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2888 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022612",
            "telephone_number": "313-871-1200",
            "fax_number": "313-871-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2888 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022612",
            "telephone_number": "313-871-1200",
            "fax_number": "313-871-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DMC CLINICAL LAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ASFAW",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-871-1200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "039079",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2098417",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taynia Dluge
• DMC
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• DMC Education & Research
• DMC Orthopedic Billing Associates LLC (DMC Billing Associates, LLC)
• DMC Primary Care Services II
• DMC University Laboratories
• DMC/Wsu

• Clinical Medical Laboratory in Detroit, MI
• Providers in Detroit, 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.