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General NPI Number Information
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NPI Number | 1720920556
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Entity Type | Organization
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Legal Business Name | INSTACLEAR LABORATORY LLC
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Dates
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Enumeration Date | 04/09/2026
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Last Update Date | 04/09/2026
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Provider Practice Location Address
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Address Line | 21409 KELLY RD
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City | EASTPOINTE
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State | MI
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Zip | 48021-3264
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Country | US
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Telephone | 586-222-6208
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Fax |
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Provider Business Mailing Address
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Address Line | 11805 KENMOOR ST
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City | DETROIT
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State | MI
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Zip | 48205-3369
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Country | US
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Telephone | 586-222-6208
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIARA ROBERTS
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Credential |
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Telephone | 313-471-0463
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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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