Organization
CLINICAL LABORATORY OF MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DIKE AJIRI (CEO)
(248) 799-0086
Entity
Organization
Contact information
Practice address
24445 NORTHWESTERN HWY, SUITE 208, SOUTHFIELD, MI 48075-6501
(248) 799-0086
(248) 750-0714
Mailing address
3319 N ELSTON AVE, SUITE 200, CHICAGO, IL 60618-5811
(773) 751-7200
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
23D2007657
MI
Other
Enumeration date
05/15/2012
Last updated
02/19/2013
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