23D0382352 CLIA NUMBER - PORTAGE HOSPITAL, LLC

Laboratory Demographics

  • CLIA Code: 23D0382352
  • Facility Name: PORTAGE HOSPITAL, LLC
  • Facility Address: 500 CAMPUS DRIVE
    HANCOCK, MI
    ZIP 49930
  • Facility Phone: 906 487-7826
  • Facility Type: Hospital
  • Facility Type: Accreditation
  • Lab Director: PETIO V. KOTOV
  • NPI Number: 1134574940
  • Taxonomy: 333300000X - Emergency Response System Companies

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CLIA Record

Field Name Field Value
CLIA Number 23D0382352
LAB Type Hospital
Facility Name PORTAGE HOSPITAL, LLC
Street 500 CAMPUS DRIVE
City HANCOCK
State MI
ZIP 49930
Phone 906 487-7826
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 1/3/2025
Certificate Expiration Date 1/2/2027
Facility Type Hospital
Lab Director PETIO V. KOTOV

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