23D0364136 CLIA NUMBER - RONALDO BALBOA MD

Laboratory Demographics

  • CLIA Code: 23D0364136
  • Facility Name: RONALDO BALBOA MD
  • Facility Address: 1201 STONE STREET STE 5
    PORT HURON, MI
    ZIP 48060
  • Facility Phone: 810 985-1850
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RONALDO S. BALBOA
  • NPI Number: 1417941055
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D0364136
LAB Type Physician Office
Facility Name RONALDO BALBOA MD
Street 1201 STONE STREET STE 5
City PORT HURON
State MI
ZIP 48060
Phone 810 985-1850
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director RONALDO S. BALBOA

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This page was last updated on: 9/29/2025