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27209 Lahser Rd Ste 130 Southfield MI 48034-8401 | |
| (313) 263-3275 | |
| (866) 279-4704 |
| Full Name | |
|---|---|
| Speciality | Physiological Laboratory |
| Location | 27209 Lahser Rd Ste 130, Southfield, Michigan |
| Authorized Official Name and Position | Charles Alvarez (CEO) |
| Authorized Official Contact | 4699958416 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
4545 Fuller Dr Suite 100 Irving TX 75038-6530 Ph: (469) 995-8416 | 27209 Lahser Rd Ste 130 Southfield MI 48034-8401 Ph: (313) 263-3275 |
| NPI Number | 1982149738 |
|---|---|
| Provider Enumeration Date | 01/04/2017 |
| Last Update Date | 01/07/2025 |
| Medicare PECOS PAC ID | 4587922471 |
|---|---|
| Medicare Enrollment ID | O20171226000518 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982149738 | NPI | - | NPPES |
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