23D1050837 CLIA NUMBER - CLARK TOWNSHIP

Laboratory Demographics

  • CLIA Code: 23D1050837
  • Facility Name: CLARK TOWNSHIP
  • Facility Address: 212 S MERIDIAN
    CEDARVILLE, MI
    ZIP 49719
  • Facility Phone: 906 484-2672
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: KEITH A. MCGOWAN JR
  • NPI Number: 1790860278
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 23D1050837
LAB Type Ambulance
Facility Name CLARK TOWNSHIP
Street 212 S MERIDIAN
City CEDARVILLE
State MI
ZIP 49719
Phone 906 484-2672
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2024
Certificate Expiration Date 2/13/2026
Facility Type Ambulance
Lab Director KEITH A. MCGOWAN JR

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