23D1059577 CLIA NUMBER - BEACON AMBULANCE SERVICE INC

Laboratory Demographics

  • CLIA Code: 23D1059577
  • Facility Name: BEACON AMBULANCE SERVICE INC
  • Facility Address: 101 E CLOVERLAND DRIVE
    IRONWOOD, MI
    ZIP 49938
  • Facility Phone: 906 932-4140
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: RANDY G. FORSTROM
  • NPI Number: 1649228123
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 23D1059577
LAB Type Ambulance
Facility Name BEACON AMBULANCE SERVICE INC
Street 101 E CLOVERLAND DRIVE
City IRONWOOD
State MI
ZIP 49938
Phone 906 932-4140
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2024
Certificate Expiration Date 10/2/2026
Facility Type Ambulance
Lab Director RANDY G. FORSTROM

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