23D1076179 CLIA NUMBER - MUNSON HEALTHCARE CHARLEVOIX WOMEN'S HEALTH

Laboratory Demographics

CLIA Number: 23D1076179

Facility Name: MUNSON HEALTHCARE CHARLEVOIX WOMEN'S HEALTH

Facility Address:
14651 W UPRIGHT STREET
CHARLEVOIX, MI
ZIP 49720
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Facility Phone Number: 231 547-4477

Facility Type: Ancillary Testing Site in Health Care Center

Certificate Type: Microscopy

NPI Number: 1730722810

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D1076179
LAB Type	Ancillary Testing Site in Health Care Center
Facility Name	MUNSON HEALTHCARE CHARLEVOIX WOMEN'S HEALTH
Street	14651 W UPRIGHT STREET
City	CHARLEVOIX
State	MI
ZIP	49720
Phone	231 547-4477
CertificateType	3
CertificateEffectiveDate	11/7/2023
CertificateExpirationDate	11/6/2025
FacilityType	PPMP

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