23D2215183 CLIA NUMBER - MI PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 23D2215183
  • Facility Name: MI PRIMARY CARE
  • Facility Address: 4950 E BLUEGRASS ROAD
    MOUNT PLEASANT, MI
    ZIP 48858
  • Facility Phone: 989 817-4640
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERTA S. HAHN
  • NPI Number: 1104441302
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2215183
LAB Type Physician Office
Facility Name MI PRIMARY CARE
Street 4950 E BLUEGRASS ROAD
City MOUNT PLEASANT
State MI
ZIP 48858
Phone 989 817-4640
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2025
Certificate Expiration Date 2/28/2027
Facility Type Physician Office
Lab Director ROBERTA S. HAHN

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