23D0375140 CLIA NUMBER - KINGSTON FAMILY HEALTHCARE MARLETTE REGIONAL HOSPITAL

Laboratory Demographics

CLIA Number: 23D0375140

Facility Name: KINGSTON FAMILY HEALTHCARE MARLETTE REGIONAL HOSPITAL

Facility Address:
5988 STATE STREET, P O BOX 256
KINGSTON, MI
ZIP 48741
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Facility Phone Number: 989 635-4330

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1306999024

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D0375140
LAB Type	Community Clinic
Facility Name	KINGSTON FAMILY HEALTHCARE MARLETTE REGIONAL HOSPITAL
Street	5988 STATE STREET, P O BOX 256
City	KINGSTON
State	MI
ZIP	48741
Phone	989 635-4330
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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