23D2010433 CLIA NUMBER - PROMEDICA CHARLES & VIRGINIA HICKMAN HOSPITAL

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Laboratory Demographics

CLIA Number: 23D2010433

Facility Name: PROMEDICA CHARLES & VIRGINIA HICKMAN HOSPITAL

Facility Address:
5640 N ADRIAN HWY
ADRIAN, MI
ZIP 49221
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Facility Phone Number: 517 577-0931

Facility Type: Other - OUTPATIENT DRAW

Certificate Type: Waiver

NPI Number: 1285107151

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	23D2010433
LAB Type	Other - OUTPATIENT DRAW
Facility Name	PROMEDICA CHARLES & VIRGINIA HICKMAN HOSPITAL
Street	5640 N ADRIAN HWY
City	ADRIAN
State	MI
ZIP	49221
Phone	517 577-0931
CertificateType	4
CertificateEffectiveDate	7/28/2022
CertificateExpirationDate	7/27/2024
FacilityType	Waiver

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