23D2036102 CLIA NUMBER - MIDMICHIGAN MEDICAL OFFICES BEAVERTON

Laboratory Demographics

  • CLIA Code: 23D2036102
  • Facility Name: MIDMICHIGAN MEDICAL OFFICES BEAVERTON
  • Facility Address: 439 S ROSS STREET
    BEAVERTON, MI
    ZIP 48612
  • Facility Phone: 989 422-5122
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: WESLEY M. PAUL
  • NPI Number: 1912998287
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2036102
LAB Type Federally Qualified Health Center
Facility Name MIDMICHIGAN MEDICAL OFFICES BEAVERTON
Street 439 S ROSS STREET
City BEAVERTON
State MI
ZIP 48612
Phone 989 422-5122
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2024
Certificate Expiration Date 1/31/2026
Facility Type Federally Qualified Health Center
Lab Director WESLEY M. PAUL

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