23D2271986 CLIA NUMBER - OHANA MEDICAL GROUP

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Laboratory Demographics

CLIA Number: 23D2271986

Facility Name: OHANA MEDICAL GROUP

Facility Address:
1218 E GRAND RIVER AVENUE
PORTLAND, MI
ZIP 48875
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Facility Phone Number: 517 732-8877

Facility Type: Other - GENERAL MEDICAL CLINIC

Certificate Type: Waiver

NPI Number: 1497492706

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	23D2271986
LAB Type	Other - GENERAL MEDICAL CLINIC
Facility Name	OHANA MEDICAL GROUP
Street	1218 E GRAND RIVER AVENUE
City	PORTLAND
State	MI
ZIP	48875
Phone	517 732-8877
CertificateType	4
CertificateEffectiveDate	11/14/2022
CertificateExpirationDate	11/13/2024
FacilityType	Waiver

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