Organization
AFFINITY LAB
Active
Organization
AFFINITY LAB
Active
Parent organization
PHOENIX MEDICAL GROUP, PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX MEDICAL GROUP, PC
Authorized official
MRS. ABBIE HILL (ADMIN)
(248) 304-7674
Entity
Organization
Contact information
Practice address
29201 TELEGRAPH RD STE 400, SOUTHFIELD, MI 48034-7647
(248) 552-8525
(248) 552-1134
Mailing address
29201 TELEGRAPH RD STE 450, SOUTHFIELD, MI 48034-7604
(248) 304-7659
(248) 423-4683
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23D2080682
CLIA
MI
Enumeration date
12/23/2014
Last updated
03/22/2018
Update your record
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