23D1042026 CLIA NUMBER - WHITE LAKE AMBULANCE AUTHORITY

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Laboratory Demographics

CLIA Number: 23D1042026

Facility Name: WHITE LAKE AMBULANCE AUTHORITY

Facility Address:
8220 WHITEHALL ROAD
WHITEHALL, MI
ZIP 49461
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Facility Phone Number: 231 894-4306

Facility Type: Ambulance

Certificate Type: Waiver

NPI Number: 1225033855

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	23D1042026
LAB Type	Ambulance
Facility Name	WHITE LAKE AMBULANCE AUTHORITY
Street	8220 WHITEHALL ROAD
City	WHITEHALL
State	MI
ZIP	49461
Phone	231 894-4306
CertificateType	4
CertificateEffectiveDate	6/17/2023
CertificateExpirationDate	6/16/2025
FacilityType	Waiver

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