23D2181464 CLIA NUMBER - BELLA ROSE SKIN CARE AND WELLNESS CENTER

Laboratory Demographics

CLIA Number: 23D2181464

Facility Name: BELLA ROSE SKIN CARE AND WELLNESS CENTER

Facility Address:
104 N 2ND AVENUE
ALPENA, MI
ZIP 49707
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Facility Phone Number: 989 464-1883

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1669004875

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D2181464
LAB Type	Physician Office
Facility Name	BELLA ROSE SKIN CARE AND WELLNESS CENTER
Street	104 N 2ND AVENUE
City	ALPENA
State	MI
ZIP	49707
Phone	989 464-1883
CertificateType	4
CertificateEffectiveDate	9/15/2023
CertificateExpirationDate	9/14/2025
FacilityType	Waiver

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