23D1040000 CLIA NUMBER - ANGELA BADRA DO PC

Laboratory Demographics

CLIA Number: 23D1040000

Facility Name: ANGELA BADRA DO PC

Facility Address:
204 W EXCHANGE STREET
OWOSSO, MI
ZIP 48867
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Facility Phone Number: 989 723-0046

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1508077140

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	23D1040000
LAB Type	Physician Office
Facility Name	ANGELA BADRA DO PC
Street	204 W EXCHANGE STREET
City	OWOSSO
State	MI
ZIP	48867
Phone	989 723-0046
CertificateType	4
CertificateEffectiveDate	4/27/2023
CertificateExpirationDate	4/26/2025
FacilityType	Waiver

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