23D0935908 CLIA NUMBER - PHYSICIAN HEALTHCARE NETWORK

Laboratory Demographics

  • CLIA Code: 23D0935908
  • Facility Name: PHYSICIAN HEALTHCARE NETWORK
  • Facility Address: 1231 PINE GROVE AVENUE SUITE 2A
    PORT HURON, MI
    ZIP 48060
  • Facility Phone: 810 982-8742
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KAVITA M. TUMMA
  • NPI Number: 1245445972
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D0935908
LAB Type Physician Office
Facility Name PHYSICIAN HEALTHCARE NETWORK
Street 1231 PINE GROVE AVENUE SUITE 2A
City PORT HURON
State MI
ZIP 48060
Phone 810 982-8742
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2024
Certificate Expiration Date 5/21/2026
Facility Type Physician Office
Lab Director KAVITA M. TUMMA

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