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Organization

STAMP CLINICAL LABORATORY,INC

Active
Other names
PREMIERE DIAGNOSTICS LABORATORY
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHOBHA STAMPWALA (ADMINISTRATOR)
(586) 939-8700
Entity
Organization

Contact information

Practice address
2567 METROPOLITAN PKWY, SUITE 105, STERLING HEIGHTS, MI 48310-7146
(586) 939-8700
(586) 939-8744
Mailing address
2567 METROPOLITAN PKWY, SUITE 105, STERLING HEIGHTS, MI 48310-7146
(586) 939-8700
(586) 939-8744

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0E01538
BCBS PIN NUMBER
MI
05
2121829
MI
Enumeration date
05/23/2007
Last updated
08/22/2020
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