23D1042026 CLIA NUMBER - WHITE LAKE AMBULANCE AUTHORITY

Laboratory Demographics

  • CLIA Code: 23D1042026
  • Facility Name: WHITE LAKE AMBULANCE AUTHORITY
  • Facility Address: 8220 WHITEHALL ROAD
    WHITEHALL, MI
    ZIP 49461
  • Facility Phone: 231 894-4306
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: JONATHAN DEGEN
  • NPI Number: 1225033855
  • Taxonomy: 3416L0300X - Ambulance

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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
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2023
Certificate Expiration Date 6/16/2025
Facility Type Ambulance
Lab Director JONATHAN DEGEN

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This page was last updated on: 3/20/2025