IMMUNE & DIAGNOSTIC LABORATORY INC. (NPI# 1083770366) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083770366 |
| Entity Type | Organization |
| Organization Name | IMMUNE & DIAGNOSTIC LABORATORY INC. |
| Practice Address |
31700 W 12 Mile Rd Ste 220 Farmington Hills MI 48334-4424 |
| Practice Telephone | 2488489000 |
| Practice Fax Number | 2484890058 |
| Mailing Telephone | 2488489000 |
| Mailing Fax Number | 2484890058 |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MOHAMED B SALKINI (PRESIDENT) |
| Authorized Official Telephone | 2488489000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | MI | Laboratories |
| Street Address |
31700 W 12 MILE RD STE 220 |
| City | FARMINGTON HILLS |
| State | MI |
| Zip Code | 48334-4424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447350202 | Tracy Renea Juliao | Psychologist | 31700 W 12 Mile Rd, Suite 250, Farmington Hills, MI 48334-4424 | 2006-09-22 |
| 1821628116 | Mackenzie Kostizen | Psychologist | 31700 W 12 Mile Rd, Farmington Hills, MI 48334-4424 | 2020-01-25 |
| 1700366028 | Bernadine Ann Bishop | Psychologist | 31700 W 12 Mile Rd, Farmington Hills, MI 48334-4424 | 2018-08-16 |
| 1215473855 | Alexandria Grace Case | Counselor | 31700 W 12 Mile Rd, Suite 250, Farmington Hills, MI 48334-4424 | 2017-01-06 |
| 1801348420 | Total Health & Wellness Associates | Counselor | 31700 W 12 Mile Rd, Suite 250, Farmington Hills, MI 48334-4424 | 2016-10-31 |
| 1174984025 | Rebecca Paez | Counselor | 31700 W 12 Mile Rd, Suite 250, Farmington Hills, MI 48334-4424 | 2016-03-18 |
| 1144591322 | Leena Hadied | Psychologist | 31700 W 12 Mile Rd, Suite 250, Farmington Hills, MI 48334-4424 | 2012-01-20 |
| 1023328572 | Christine Sebastian | Psychologist | 31700 W 12 Mile Rd, Suite 250, Farmington Hills, MI 48334-4424 | 2010-10-18 |
| 1104151950 | Total Health & Wellness Associates | Psychologist | 31700 W 12 Mile Rd, Suite 250, Farmington Hills, MI 48334-4424 | 2009-10-13 |
| 1326286329 | Principal Home Healthcare,llc | Home Health | 31700 W 12 Mile Rd, Suite 200, Farmington Hills, MI 48334-4424 | 2009-01-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588264535 | Kiah Bradley | Behavior Technician | 2777 Inkster Rd Suite 100, Farmington Hills, MI 48334 | 2020-10-29 |
| 1417557307 | Carsen D Dresbach | Behavior Technician | 2777 Inster Road Suite 100, Farmington Hills, MI 48334 | 2020-10-29 |
| 1316560303 | Amy K Pruneau LLC | Psychologist | 26755 Middlebelt Rd Ste 140, Farmington Hills, MI 48334 | 2020-05-25 |
| 1366089732 | Vian Aljony | Dental Hygienist | 27273 Arden Park Cir, Farmington Hills, MI 48334 | 2019-12-04 |
| 1699311902 | Sandra Zori | Pharmacist | 27800 Middlebelt Rd, Farmington Hills, MI 48334 | 2019-11-21 |
| 1902450471 | Kianna Marie Garcia | Behavior Technician | 27777 Inkster Rd., Farmington Hills, MI 48334 | 2019-08-01 |
| 1619521176 | Samantha Serra | Behavior Technician | 27777 Inkster Rd Suite 100, Farmington Hills, MI 48334 | 2019-08-01 |
| 1851945398 | Kristen Butler | Behavior Technician | 27777 Inkster Road Suite 100, Farmington Hills, MI 48334 | 2019-08-01 |
| 1104489038 | Katherine Kalsow | Behavioral Analyst | 27777 Inkster Rd. Suite 100, Farmington Hills, MI 48334 | 2019-04-16 |
| 1083178487 | Imee Raterta | Physical Therapist | Ability Works Rehab, 28592 Orchard Lake Rd # 300, Farmington Hills, MI 48334 | 2019-01-30 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306350194 | Medical Laboratory Service Inc | Clinical Medical Laboratory | 31700 W 13 Mile Rd Ofc 218, Farmington Hills, MI 48334-2170 | 2017-12-01 |
| 1306276951 | Biolabotix, LLC | Clinical Medical Laboratory | 33469 W 14 Mile Rd Ste 130, Farmington Hills, MI 48331-1511 | 2013-11-18 |
| 1710237870 | Apollo Diagnostics Laboratory Inc | Clinical Medical Laboratory | 21999 Farmington Rd, Suite 100, Farmington Hills, MI 48336-4400 | 2012-09-17 |
| 1336464668 | Great Lakes Medical Laboratory Inc | Clinical Medical Laboratory | 33469 W. 14 Miles Rd, Suite 120, Farmington Hills, MI 48331-6108 | 2010-03-30 |
| 1043377500 | Detroit Bio Medical Labs Inc | Clinical Medical Laboratory | 23955 Freeway Park Dr, Farmington Hills, MI 48335-2817 | 2007-01-03 |
| 1447506787 | Suburban Medical Laboratory, Inc. | Clinical Medical Laboratory | 39303 Country Club Dr, Suite C-30, Farmington Hills, MI 48331-3478 | 2012-07-24 |
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| 1952918831 | United Medical Laboratory LLC | Clinical Medical Laboratory | 30675 Stephenson Hwy, Suite B, Madison Heights, MI 48071 | 2020-09-25 |
| 1407466253 | Van Laan Industries Inc. | Clinical Medical Laboratory | 3414 Lovers Ln Ste A, Kalamazoo, MI 49001-4806 | 2020-08-06 |
| 1164049524 | Rapid Biosense LLC | Clinical Medical Laboratory | 46701 Commerce Center Dr, Plymouth, MI 48170-2475 | 2020-07-01 |
| 1023631595 | Catalyst Diagnostic LLC | Clinical Medical Laboratory | 4942 Dawn Ave Ste 210, East Lansing, MI 48823-5606 | 2020-05-19 |
| 1467073460 | Lynx Dx Inc | Clinical Medical Laboratory | 333 Jackson Plz Ste 600, Ann Arbor, MI 48103-1922 | 2020-04-30 |
| 1184245219 | Olive Labs, Inc. | Clinical Medical Laboratory | 150 Livernois St, Ferndale, MI 48220-2302 | 2020-04-29 |
| 1720617947 | Covenant Pathology Associates, PC | Clinical Medical Laboratory | 4707 Mcleod Dr E, Saginaw, MI 48604-2853 | 2020-04-08 |
| 1134757339 | Vibra of Southeastern Michigan, LLC | Clinical Medical Laboratory | 1307-a Allen Drive, Troy, MI 48083-4010 | 2020-04-01 |
| 1972137560 | Functional Fluidics LLC | Clinical Medical Laboratory | 440 Burroughs St Ste 641, Detroit, MI 48202-3474 | 2020-02-24 |
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| City | FARMINGTON HILLS |
| Zip Code | 48334 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.