Great Lakes Medical Laboratories, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

GREAT LAKES MEDICAL LABORATORIES, INC.

Practice address

13530 Michigan Ave
Suite 248
Dearborn, MI 48126-3574

Phone

(248) 770-8707

NPI assigned

Sep 26, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Husain Ali Saleh, M.D.NPI 1992743017

Title

President

Phone

(248) 770-8707

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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.

• Husain A Saleh, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Detroit, MI
  • NPI 1992743017
  NPD Authorized official

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1992088918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13530 MICHIGAN AVE",
            "address_2": "SUITE 248",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263574",
            "telephone_number": "248-770-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13530 MICHIGAN AVE",
            "address_2": "SUITE 248",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263574",
            "telephone_number": "248-770-8707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES MEDICAL LABORATORIES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-26",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "SALEH",
        "authorized_official_first_name": "HUSAIN",
        "authorized_official_middle_name": "ALI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-770-8707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Gray
• Brandi Nicole Grays
• Jeffery Allen Grayson
• Great Lakes Cardiovascular & Thoracic Surgeons
• Great Lakes Med Solutions LLC
• Great Lakes Musculoskeletal Ultrasound Inc. (Great Lakes MSK US INC.)
• Great Lakes Pediatric Neurology
• Great Lakes Porter SVC
• Great Lakes Reading, PLLC
• Greater Detroit Community Care

• Clinical Medical Laboratory in Dearborn, MI
• Providers in Dearborn, 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 Sep 17, 2013; 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.