23D1101536 CLIA NUMBER - MEMORIAL HEALTHCARE FAMILY MEDICINE - CORUNNA

Laboratory Demographics

  • CLIA Code: 23D1101536
  • Facility Name: MEMORIAL HEALTHCARE FAMILY MEDICINE - CORUNNA
  • Facility Address: 239 N STATE ROAD SUITE 101
    OWOSSO, MI
    ZIP 48867
  • Facility Phone: 989 743-3415
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARYAM SOMO
  • NPI Number: 1215273941
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D1101536
LAB Type Physician Office
Facility Name MEMORIAL HEALTHCARE FAMILY MEDICINE - CORUNNA
Street 239 N STATE ROAD SUITE 101
City OWOSSO
State MI
ZIP 48867
Phone 989 743-3415
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/29/2025
Certificate Expiration Date 6/28/2027
Facility Type Physician Office
Lab Director MARYAM SOMO

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