Organization
BIOCHEM DIAGNOSTICS LABORATORY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEOFIL GHERASIM (PRESIDENT)
(248) 837-0868
Entity
Organization
Contact information
Practice address
18161 W 13 MILE RD, SUITE D3, SOUTHFIELD, MI 48076-1113
(248) 837-0868
(888) 636-1826
Mailing address
18161 W 13 MILE RD, SUITE D3, SOUTHFIELD, MI 48076-1113
(248) 837-0868
(888) 636-1826
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23D2084247
CLIA
MI
Enumeration date
10/09/2014
Last updated
01/07/2015
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