23D0907085 CLIA NUMBER - NORTHWESTERN MICHIGAN COLLEGE STUDENT HEALTH SERVICES

Laboratory Demographics

CLIA Number: 23D0907085

Facility Name: NORTHWESTERN MICHIGAN COLLEGE STUDENT HEALTH SERVICES

Facility Address:
1701 E FRONT STREET LB 106
TRAVERSE CITY, MI
ZIP 49686
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Facility Phone Number: 231 995-1255

Facility Type: School/Student Health Service

Certificate Type: Microscopy

NPI Number: 1700033859

Taxonomy: 261QS1000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D0907085
LAB Type	School/Student Health Service
Facility Name	NORTHWESTERN MICHIGAN COLLEGE STUDENT HEALTH SERVICES
Street	1701 E FRONT STREET LB 106
City	TRAVERSE CITY
State	MI
ZIP	49686
Phone	231 995-1255
CertificateType	3
CertificateEffectiveDate	6/7/2022
CertificateExpirationDate	6/6/2024
FacilityType	PPMP

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