Organization
BIOTECH CLINICAL LABORATORIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GIOVANNI KHALIFEH (VICE PRESIDENT)
(248) 912-1700
Entity
Organization
Contact information
Practice address
25775 MEADOWBROOK RD, NOVI, MI 48375-1849
(248) 912-1700
(248) 912-1730
Mailing address
25775 MEADOWBROOK RD, NOVI, MI 48375-1849
(248) 912-1700
(248) 912-1730
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
23D0709666
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F31535
BCBS
MI
05
—
2928322
—
MI
Enumeration date
05/23/2005
Last updated
04/27/2015
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