23D2079665 CLIA NUMBER - MENOMINEE FAMILY HEALTH CENTER

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Laboratory Demographics

CLIA Number: 23D2079665

Facility Name: MENOMINEE FAMILY HEALTH CENTER

Facility Address:
1110 10TH AVENUE
MENOMINEE, MI
ZIP 49858
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Facility Phone Number: 906 290-5000

Facility Type: Federally Qualified Health Center

Certificate Type: Waiver

NPI Number: 1801214218

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D2079665
LAB Type	Federally Qualified Health Center
Facility Name	MENOMINEE FAMILY HEALTH CENTER
Street	1110 10TH AVENUE
City	MENOMINEE
State	MI
ZIP	49858
Phone	906 290-5000
CertificateType	4
CertificateEffectiveDate	6/20/2022
CertificateExpirationDate	6/19/2024
FacilityType	Waiver

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