23D2116636 CLIA NUMBER - MYMICHIGAN COMMUNITY CARE - SAULT

Laboratory Demographics

  • CLIA Code: 23D2116636
  • Facility Name: MYMICHIGAN COMMUNITY CARE - SAULT
  • Facility Address: 509 OSBORN BLVD SUITE 160 M O B
    SAULT SAINTE MARIE, MI
    ZIP 49783
  • Facility Phone: 906 253-2605
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: KEVIN SORAH
  • NPI Number: 1609933589
  • Taxonomy: 207RC0000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2116636
LAB Type Community Clinic
Facility Name MYMICHIGAN COMMUNITY CARE - SAULT
Street 509 OSBORN BLVD SUITE 160 M O B
City SAULT SAINTE MARIE
State MI
ZIP 49783
Phone 906 253-2605
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2024
Certificate Expiration Date 7/28/2026
Facility Type Community Clinic
Lab Director KEVIN SORAH

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