DOWNRIVER CLINIC PC
NPI 1104063817
Clinic/Center - Urgent Care in Grosse Ile, MI

Q: What is Downriver Clinic PC's NPI number?

The NPI number for Downriver Clinic PC is 1104063817. It was assigned to this organization in the NPPES registry on January 16, 2009.

Q: What is Downriver Clinic PC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Urgent Care, with taxonomy code 261QU0200X.

Active since January 16, 2009CLIA 23D1093973 · Waiver

8944 MACOMB ST, GROSSE ILE, MI 48138(734) 675-0705(734) 675-0747 Get Directions Write a Review

NPPES record last updated: April 14, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Downriver Clinic Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOWNRIVER CLINIC PC (NPI 1104063817) is a healthcare organization registered as an urgent care in Grosse Ile, Michigan and active in the NPI registry since January 2009. The organization holds a CLIA Waiver certificate valid through January 6, 2027 and lists Mounir Khaled, Owner Medical Director Physician, as its authorized official.

NPPES Registry Identity

NPI1104063817

Entity TypeOrganization

Primary Taxonomy261QU0200X

Legal Business NameDOWNRIVER CLINIC PC

Location Address8944 MACOMB STGrosse Ile, MI 48138-2089

Mailing Address8944 Macomb StGrosse Ile, MI 48138-2089 · (734) 675-0705 · Fax (734) 675-0747

Phone(734) 675-0705

Fax(734) 675-0747

Organization SubpartNo

Authorized OfficialMounir KhaledOwner Medical Director Physician · (734) 675-0705

Enumeration DateJanuary 16, 2009

Last NPPES UpdateApril 14, 2009

✔ NPI 1104063817 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Urgent CareAmbulatory Health Care Facilities

Taxonomy Code261QU0200X

License✔ Licensed in MI · 4301091157

8944 MACOMB ST, Grosse Ile, MI 48138

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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 23D1093973

Down River Clinic PC · Grosse Ile, MI

Active · expires Jan 6, 2027

CLIA Number23D1093973

Laboratory TypeOther

Certificate Effective DateJanuary 7, 2025

Certificate Expiration DateJanuary 6, 2027

Laboratory DirectorMounir K. Khaled

Laboratory Phone(734) 675-0705

Laboratory LocationDown River Clinic PC8944 Macomb Road, Grosse Ile, MI 48138

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory to perform only waived tests.

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Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DOWNRIVER CLINIC PC

Internal Medicine