23D0377816 CLIA NUMBER - BRONSON LAKEVIEW FAMILY CARE - PAW PAW

Laboratory Demographics

CLIA Number: 23D0377816

Facility Name: BRONSON LAKEVIEW FAMILY CARE - PAW PAW

Facility Address:
451 HEALTH PARKWAY STE G
PAW PAW, MI
ZIP 49079
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Facility Phone Number: 269 655-3037

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1447474267

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D0377816
LAB Type	Physician Office
Facility Name	BRONSON LAKEVIEW FAMILY CARE - PAW PAW
Street	451 HEALTH PARKWAY STE G
City	PAW PAW
State	MI
ZIP	49079
Phone	269 655-3037
CertificateType	3
CertificateEffectiveDate	3/2/2024
CertificateExpirationDate	3/1/2026
FacilityType	PPMP

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