23D0895434 CLIA NUMBER - BRONSON LAKEVIEW FAMILY CARE BANGOR

Laboratory Demographics

  • CLIA Code: 23D0895434
  • Facility Name: BRONSON LAKEVIEW FAMILY CARE BANGOR
  • Facility Address: 520 RAILROAD STREET
    BANGOR, MI
    ZIP 49013
  • Facility Phone: 269 427-5811
  • Facility Type: Rural Health Clinic
  • Facility Type: Microscopy
  • Lab Director: CARALYN K. DEHAAN
  • NPI Number: 1104459627
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D0895434
LAB Type Rural Health Clinic
Facility Name BRONSON LAKEVIEW FAMILY CARE BANGOR
Street 520 RAILROAD STREET
City BANGOR
State MI
ZIP 49013
Phone 269 427-5811
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 1/12/2024
Certificate Expiration Date 1/11/2026
Facility Type Rural Health Clinic
Lab Director CARALYN K. DEHAAN

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