23D2132976 CLIA NUMBER - AMANDA K NIXON PA-C, P C

Laboratory Demographics

  • CLIA Code: 23D2132976
  • Facility Name: AMANDA K NIXON PA-C, P C
  • Facility Address: 202 S HOWARD ST P O BOX 74
    TUSTIN, MI
    ZIP 49688
  • Facility Phone: 231 465-4165
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMANDA K. NIXON
  • NPI Number: 1912250861
  • Taxonomy: 363AM0700X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 23D2132976
LAB Type Physician Office
Facility Name AMANDA K NIXON PA-C, P C
Street 202 S HOWARD ST P O BOX 74
City TUSTIN
State MI
ZIP 49688
Phone 231 465-4165
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/3/2025
Certificate Expiration Date 7/2/2027
Facility Type Physician Office
Lab Director AMANDA K. NIXON

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