Active NPI
Histology Associates Inc
- Clinical Medical Laboratory
- Garden City, MI
National Provider Identifier
1649273459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- HISTOLOGY ASSOCIATES INC
- Practice address
- 29430 Ford Rd
Garden City, MI 48135-2318 - Phone
- (313) 979-0792
- Fax
- (586) 774-4220
- NPI assigned
- May 24, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Fadlallah Kassem
- Title
- Owner
- Phone
- (313) 979-0792
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Pathology Physician | 207ZC0006X | |||
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
29430 Ford Rd
Garden City, MI 48135-2318
Mailing address
29430 Ford Rd
Garden City, MI 48135-2318
Phone (313) 979-0792
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 23D0650582 | Other | MI | CLIA |
Other names 1
- Acculab Dx
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041104000242 | MI | Part B Supplier - Independent Clinical Laboratory | 4587627286 | Practice locations: Saint Clair Shores, MI |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 23D0650582 | Histology Associates | Accreditation | Jan 18, 2028 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
Locations
22221 Greater Mack Ave
St Clr Shores, MI 48080
Phone (248) 890-4584
22108 Harper Ave
St Clr Shores, MI 48080
Phone (586) 774-4290
22221 Greater Mack Ave
Ste E
St Clr Shores, MI 48080
Phone (586) 774-4290
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116892800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1785196800000",
"number": "1649273459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "29430 FORD RD",
"city": "GARDEN CITY",
"state": "MI",
"postal_code": "481352318",
"telephone_number": "313-979-0792",
"fax_number": "586-774-4220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29430 FORD RD",
"city": "GARDEN CITY",
"state": "MI",
"postal_code": "481352318",
"telephone_number": "313-979-0792",
"fax_number": "586-774-4220"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HISTOLOGY ASSOCIATES INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-05-24",
"last_updated": "2026-07-28",
"certification_date": "2026-07-28",
"status": "A",
"authorized_official_last_name": "KASSEM",
"authorized_official_first_name": "FADLALLAH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "313-979-0792"
},
"taxonomies": [
{
"code": "207ZC0006X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pathology, Clinical Pathology",
"state": null,
"license": null,
"primary": false
},
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA",
"identifier": "23D0650582",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Acculab Dx",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Garden City, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.