Organization
SHORES DIAGNOSTIC LLC
Active
Parent organization
SHORES DIAGNOSTIC LLC
Other names
Shores Diagnostic Llc
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHORES DIAGNOSTIC LLC
Authorized official
NORMA JEAN BARRETT (BILLING MANAGER)
(734) 730-7579
Entity
Organization
Contact information
Practice address
3611 CARPENTER ST STE 6, HAMTRAMCK, MI 48212-2784
(313) 285-8728
(313) 784-9055
Mailing address
3611 CARPENTER ST STE 6, HAMTRAMCK, MI 48212-2784
(313) 285-8728
(313) 784-9055
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235110289
—
MI
Enumeration date
09/28/2020
Last updated
09/28/2020
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