23D0910192 CLIA NUMBER - OSF HEALTHCARE MEDICAL GROUP - ESCANABA

Laboratory Demographics

CLIA Number: 23D0910192

Facility Name: OSF HEALTHCARE MEDICAL GROUP - ESCANABA

Facility Address:
3409 LUDINGTON STREET #100
ESCANABA, MI
ZIP 49829
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Facility Phone Number: 906 786-5707

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1063587046

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D0910192
LAB Type	Physician Office
Facility Name	OSF HEALTHCARE MEDICAL GROUP - ESCANABA
Street	3409 LUDINGTON STREET #100
City	ESCANABA
State	MI
ZIP	49829
Phone	906 786-5707
CertificateType	4
CertificateEffectiveDate	4/17/2024
CertificateExpirationDate	4/16/2026
FacilityType	Waiver

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