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General NPI Number Information
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NPI Number | 1023631595
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Entity Type | Organization
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Legal Business Name | CATALYST DIAGNOSTIC LLC
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Dates
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Enumeration Date | 05/19/2020
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Last Update Date | 08/13/2024
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Provider Practice Location Address
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Address Line | 30600 TELEGRAPH RD STE 1395
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City | BINGHAM FARMS
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State | MI
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Zip | 48025-4530
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Country | US
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Telephone | 517-885-3524
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Fax | 517-940-4260
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Provider Business Mailing Address
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Address Line | 30600 TELEGRAPH RD STE 1395
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City | BINGHAM FARMS
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State | MI
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Zip | 48025-4530
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Country | US
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Telephone | 517-885-3524
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Fax | 517-940-4260
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Authorized Official
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Title or Position | OWNER
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Name | MR. NORMAN KIMINAIA
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Credential |
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Telephone | 517-885-3524
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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