23D0376134 CLIA NUMBER - SMG SARANAC

Laboratory Demographics

CLIA Number: 23D0376134

Facility Name: SMG SARANAC

Facility Address:
107 N BRIDGE STREET
SARANAC, MI
ZIP 48881
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Facility Phone Number: 616 642-9408

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1811380066

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D0376134
LAB Type	Physician Office
Facility Name	SMG SARANAC
Street	107 N BRIDGE STREET
City	SARANAC
State	MI
ZIP	48881
Phone	616 642-9408
CertificateType	4
CertificateEffectiveDate	7/13/2023
CertificateExpirationDate	7/12/2025
FacilityType	Waiver

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