23D2222218 CLIA NUMBER - EVERGREEN HC GROUP INC DBA EVERGREEN HOME HEALTH

Laboratory Demographics

  • CLIA Code: 23D2222218
  • Facility Name: EVERGREEN HC GROUP INC DBA EVERGREEN HOME HEALTH
  • Facility Address: 403 W MAIN STREET A1
    GAYLORD, MI
    ZIP 49735
  • Facility Phone: 989 448-2778
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: KENDRA A. CHURCHES
  • NPI Number: 1184225021
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 23D2222218
LAB Type Home Health Agency
Facility Name EVERGREEN HC GROUP INC DBA EVERGREEN HOME HEALTH
Street 403 W MAIN STREET A1
City GAYLORD
State MI
ZIP 49735
Phone 989 448-2778
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Home Health Agency
Lab Director KENDRA A. CHURCHES

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