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General NPI Number Information
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NPI Number | 1669850186
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Entity Type | Organization
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Legal Business Name | MICHIGAN LABORATORY SERVICES INC
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Dates
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Enumeration Date | 05/16/2015
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Last Update Date | 05/16/2015
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Provider Practice Location Address
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Address Line | 4478 BLOOMFIELD DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-3314
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Country | US
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Telephone | 248-703-1157
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Fax |
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Provider Business Mailing Address
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Address Line | 4478 BLOOMFIELD DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-3314
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Country | US
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Telephone | 248-703-1157
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. VAIRA ALJAJAWI
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Credential | NHA
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Telephone | 248-703-1157
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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 | 06405L
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License Number State | MI
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