23D2062549 CLIA NUMBER - SPARROW IONIA HOSPITAL POC

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Laboratory Demographics

CLIA Number: 23D2062549

Facility Name: SPARROW IONIA HOSPITAL POC

Facility Address:
3565 S STATE ROAD
IONIA, MI
ZIP 48846
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Facility Phone Number: 616 523-1400

Facility Type: Hospital

Certificate Type: Waiver

NPI Number: 1295801108

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D2062549
LAB Type	Hospital
Facility Name	SPARROW IONIA HOSPITAL POC
Street	3565 S STATE ROAD
City	IONIA
State	MI
ZIP	48846
Phone	616 523-1400
CertificateType	4
CertificateEffectiveDate	7/18/2023
CertificateExpirationDate	7/17/2025
FacilityType	Waiver

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