23D0954304 CLIA NUMBER - MYMICHIGAN FAMILY MEDICINE FARWELL

Laboratory Demographics

  • CLIA Code: 23D0954304
  • Facility Name: MYMICHIGAN FAMILY MEDICINE FARWELL
  • Facility Address: 2812 W CADILLAC DRIVE
    FARWELL, MI
    ZIP 48622
  • Facility Phone: 989 588-5050
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHANNON MARTIN
  • NPI Number: 1306858824
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D0954304
LAB Type Physician Office
Facility Name MYMICHIGAN FAMILY MEDICINE FARWELL
Street 2812 W CADILLAC DRIVE
City FARWELL
State MI
ZIP 48622
Phone 989 588-5050
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Physician Office
Lab Director SHANNON MARTIN

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