23D2037570 CLIA NUMBER - MCLAREN THUMB REGION SCOTT MASON PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 23D2037570
  • Facility Name: MCLAREN THUMB REGION SCOTT MASON PRIMARY CARE
  • Facility Address: 1117 S VAN DYKE SUITE 200
    BAD AXE, MI
    ZIP 48413
  • Facility Phone: 989 269-6048
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OLIVIA K. THIEL
  • NPI Number: 1386990026
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2037570
LAB Type Physician Office
Facility Name MCLAREN THUMB REGION SCOTT MASON PRIMARY CARE
Street 1117 S VAN DYKE SUITE 200
City BAD AXE
State MI
ZIP 48413
Phone 989 269-6048
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/9/2025
Certificate Expiration Date 4/8/2027
Facility Type Physician Office
Lab Director OLIVIA K. THIEL

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