23D2264186 CLIA NUMBER - INFUSION ASSOCIATES

Laboratory Demographics

CLIA Number: 23D2264186

Facility Name: INFUSION ASSOCIATES

Facility Address:
1399 W CENTRE AVENUE
PORTAGE, MI
ZIP 49024
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Facility Phone Number: 616 954-0600

Facility Type: Other - OUT PATIENT INFUSION CTR

Certificate Type: Waiver

NPI Number: 1942334636

Taxonomy: 261QI0500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D2264186
LAB Type	Other - OUT PATIENT INFUSION CTR
Facility Name	INFUSION ASSOCIATES
Street	1399 W CENTRE AVENUE
City	PORTAGE
State	MI
ZIP	49024
Phone	616 954-0600
CertificateType	4
CertificateEffectiveDate	7/12/2022
CertificateExpirationDate	7/11/2024
FacilityType	Waiver

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