23D2037530 CLIA NUMBER - BEAR LAKE TOWNSHIP FIRE DEPT

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Laboratory Demographics

CLIA Number: 23D2037530

Facility Name: BEAR LAKE TOWNSHIP FIRE DEPT

Facility Address:
7771 LAKE STREET
BEAR LAKE, MI
ZIP 49614
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Facility Phone Number: 231 864-3620

Facility Type: Other - MEDICAL FIRST RESPONDER

Certificate Type: Waiver

NPI Number: 1891887816

Taxonomy: 251V00000X - Voluntary or Charitable

CLIA Record

Field Name	Field Value
CLIA Number	23D2037530
LAB Type	Other - MEDICAL FIRST RESPONDER
Facility Name	BEAR LAKE TOWNSHIP FIRE DEPT
Street	7771 LAKE STREET
City	BEAR LAKE
State	MI
ZIP	49614
Phone	231 864-3620
CertificateType	4
CertificateEffectiveDate	10/8/2022
CertificateExpirationDate	10/7/2024
FacilityType	Waiver

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