23D2106081 CLIA NUMBER - TRAVERSE BAY INTERNAL MEDICINE, PC

Laboratory Demographics

  • CLIA Code: 23D2106081
  • Facility Name: TRAVERSE BAY INTERNAL MEDICINE, PC
  • Facility Address: 3963 WEST ROYAL DRIVE
    TRAVERSE CITY, MI
    ZIP 49684
  • Facility Phone: 231 486-5516
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANGELA POHL
  • NPI Number: 1487023933
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2106081
LAB Type Physician Office
Facility Name TRAVERSE BAY INTERNAL MEDICINE, PC
Street 3963 WEST ROYAL DRIVE
City TRAVERSE CITY
State MI
ZIP 49684
Phone 231 486-5516
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/10/2023
Certificate Expiration Date 12/9/2025
Facility Type Physician Office
Lab Director ANGELA POHL

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