23D0881703 CLIA NUMBER - KIM MCCULLOUGH MD

Laboratory Demographics

  • CLIA Code: 23D0881703
  • Facility Name: KIM MCCULLOUGH MD
  • Facility Address: 550 OSBORN SUITE 2600
    SAULT SAINTE MARIE, MI
    ZIP 49783
  • Facility Phone: 906 635-1048
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIM L. MCCULLOUGH
  • NPI Number: 1194777680
  • Taxonomy: 208600000X - Surgery

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CLIA Record

Field Name Field Value
CLIA Number 23D0881703
LAB Type Physician Office
Facility Name KIM MCCULLOUGH MD
Street 550 OSBORN SUITE 2600
City SAULT SAINTE MARIE
State MI
ZIP 49783
Phone 906 635-1048
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2024
Certificate Expiration Date 1/16/2026
Facility Type Physician Office
Lab Director KIM L. MCCULLOUGH

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