Healthcare Provider Details

I. General information

NPI: 1356272231
Provider Name (Legal Business Name): PRIME CORES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4245 BEECH DALY ROAD 202A
DEARBORN HEIGHTS MI
48125
US

IV. Provider business mailing address

4245 BEECH DALY ROAD 202A
DEARBORN HEIGHTS MI
48125
US

V. Phone/Fax

Practice location:
  • Phone: 586-210-0861
  • Fax:
Mailing address:
  • Phone: 586-210-0861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SUMITHRA CHUNDRU
Title or Position: OWNER
Credential:
Phone: 586-210-0861