23D0374579 CLIA NUMBER - MIDMICHIGAN HEALTH PARK HOUGHTON LAKE LABORATORY

Laboratory Demographics

CLIA Number: 23D0374579

Facility Name: MIDMICHIGAN HEALTH PARK HOUGHTON LAKE LABORATORY

Facility Address:
9249-A W LAKE CITY RD
HOUGHTON LAKE, MI
ZIP 48629
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Facility Phone Number: 517 386-8854

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1114278140

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D0374579
LAB Type	Physician Office
Facility Name	MIDMICHIGAN HEALTH PARK HOUGHTON LAKE LABORATORY
Street	9249-A W LAKE CITY RD
City	HOUGHTON LAKE
State	MI
ZIP	48629
Phone	517 386-8854
CertificateType	1
CertificateEffectiveDate	12/23/2023
CertificateExpirationDate	12/22/2025
FacilityType	Accreditation

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This page was last updated on: 4/23/2024