23D0376936 CLIA NUMBER - ASCENSION BORGESS PROMED FAMILY PRACTICE THREE RIVERS

Laboratory Demographics

  • CLIA Code: 23D0376936
  • Facility Name: ASCENSION BORGESS PROMED FAMILY PRACTICE THREE RIVERS
  • Facility Address: 1241 W BROADWAY
    THREE RIVERS, MI
    ZIP 49093
  • Facility Phone: 269 273-9539
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KELLIE SANDERS-KIZER
  • NPI Number: 1629495320
  • Taxonomy: 207P00000X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D0376936
LAB Type Physician Office
Facility Name ASCENSION BORGESS PROMED FAMILY PRACTICE THREE RIVERS
Street 1241 W BROADWAY
City THREE RIVERS
State MI
ZIP 49093
Phone 269 273-9539
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2024
Certificate Expiration Date 3/31/2026
Facility Type Physician Office
Lab Director KELLIE SANDERS-KIZER

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