23D2086548 CLIA NUMBER - HOSPICE OF MICHIGAN, INC

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Laboratory Demographics

CLIA Number: 23D2086548

Facility Name: HOSPICE OF MICHIGAN, INC

Facility Address:
830 S OTSEGO AVE
GAYLORD, MI
ZIP 49735
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Facility Phone Number: 313 938-2144

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1962446237

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	23D2086548
LAB Type	Hospice
Facility Name	HOSPICE OF MICHIGAN, INC
Street	830 S OTSEGO AVE
City	GAYLORD
State	MI
ZIP	49735
Phone	313 938-2144
CertificateType	4
CertificateEffectiveDate	11/6/2022
CertificateExpirationDate	11/5/2024
FacilityType	Waiver

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