23D2003991 CLIA NUMBER - MEMORIAL HEALTHCARE FAMILY MEDICINE - KING ST

Laboratory Demographics

  • CLIA Code: 23D2003991
  • Facility Name: MEMORIAL HEALTHCARE FAMILY MEDICINE - KING ST
  • Facility Address: 818 W KING STREET SUITE 100
    OWOSSO, MI
    ZIP 48867
  • Facility Phone: 989 725-8171
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANTHONY PATSY
  • NPI Number: 1558432237
  • Taxonomy: 363A00000X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 23D2003991
LAB Type Physician Office
Facility Name MEMORIAL HEALTHCARE FAMILY MEDICINE - KING ST
Street 818 W KING STREET SUITE 100
City OWOSSO
State MI
ZIP 48867
Phone 989 725-8171
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 2/23/2024
Certificate Expiration Date 2/22/2026
Facility Type Physician Office
Lab Director ANTHONY PATSY

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