Organization Active NPI

Histology Associates Inc

  • Clinical Medical Laboratory
  • Garden City, MI
National Provider Identifier
1649273459
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
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

Updated by the provider on Jul 28, 2026

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)CodeLicenseStatePrimary
Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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

IdentifierTypeStateIssuer
23D0650582OtherMICLIA

Other names 1

  • Acculab Dx Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041104000242 MI Part B Supplier - Independent Clinical Laboratory 4587627286 Practice locations: Saint Clair Shores, MI

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
23D0650582Histology Associates29430 Ford Road, Garden City, MI 48135AccreditationJan 18, 2028

National Provider Directory

National Provider Directory

Member 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.

Verify at the official NPI Registry.