NPIMap

Organization Active NPI

Michigan Institute of Urology Laboratory

  • Clinical Medical Laboratory
  • Saint Clair Shores, MI
National Provider Identifier
1245476670
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
4301070286 Issued in MI
Legal business name
MICHIGAN INSTITUTE OF UROLOGY LABORATORY
Practice address
20952 E 12 Mile Rd Ste 200
Saint Clair Shores, MI 48081-3203
Phone
(586) 771-4820
Fax
(586) 771-6620
NPI assigned
Jan 7, 2009
Last updated
Sep 10, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
MICHIGAN INSTITUTE OF UROLOGY PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Authorized official

Name
Brian Guz, MDNPI 1174588487
Title
President
Phone
(586) 771-4820

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 4301070286 MI Primary

Addresses

Primary practice location

20952 E 12 Mile Rd Ste 200
Saint Clair Shores, MI 48081-3203

Mailing address

20952 E 12 Mile Rd
Suite 200
Saint Clair Shores, MI 48081-3200
Phone (586) 771-4820

Other identifiers 1

IdentifierTypeStateIssuer
690E02750OtherMIBCBSM

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D0696606Michigan Institute of Urology20952 12 Mile Rd, Suite 200, Saint Clair Shores, MI 48081AccreditationDec 22, 2027
23D1051456Miu Pathology Lab20952 12 Mile Road Suite 200, Saint Clair Shores, MI 48081AccreditationMay 14, 2028

National Provider Directory

National Provider Directory
Tax ID family
Alliance Physician Services of Michigan PC24 organizations share this tax ID, including this one
Part of
Alliance Physician Services of Michigan PC

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568073600000",
    "number": "1245476670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD",
            "address_2": "SUITE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813200",
            "telephone_number": "586-771-4820",
            "fax_number": "586-771-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20952 E 12 MILE RD STE 200",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813203",
            "telephone_number": "586-771-4820",
            "fax_number": "586-771-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN INSTITUTE OF UROLOGY LABORATORY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MICHIGAN INSTITUTE OF UROLOGY PC",
        "enumeration_date": "2009-01-07",
        "last_updated": "2019-09-10",
        "status": "A",
        "authorized_official_last_name": "GUZ",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-771-4820",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MI",
            "license": "4301070286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "690E02750",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.