23D2260275 CLIA NUMBER - SHELBY - BENONA FIRE DEPARTMENT

Laboratory Demographics

  • CLIA Code: 23D2260275
  • Facility Name: SHELBY - BENONA FIRE DEPARTMENT
  • Facility Address: 430 INDUSTRIAL PARK DRIVE
    SHELBY, MI
    ZIP 49455
  • Facility Phone: 231 861-5525
  • Facility Type: Other - MEDICAL RESCUE UNIT
  • Facility Type: Waiver
  • Lab Director: JACK E. WHITE
  • NPI Number: 1508824277
  • Taxonomy: 363L00000X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 23D2260275
LAB Type Other - MEDICAL RESCUE UNIT
Facility Name SHELBY - BENONA FIRE DEPARTMENT
Street 430 INDUSTRIAL PARK DRIVE
City SHELBY
State MI
ZIP 49455
Phone 231 861-5525
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2024
Certificate Expiration Date 5/16/2026
Facility Type Other - MEDICAL RESCUE UNIT
Lab Director JACK E. WHITE

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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