23D2282143 CLIA NUMBER - BLUE WATER URGENT CARE PORT HURON

Laboratory Demographics

CLIA Number: 23D2282143

Facility Name: BLUE WATER URGENT CARE PORT HURON

Facility Address:
1612 10TH AVENUE
PORT HURON, MI
ZIP 48060
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Facility Phone Number: 810 660-0242

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1548957707

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	23D2282143
LAB Type	Physician Office
Facility Name	BLUE WATER URGENT CARE PORT HURON
Street	1612 10TH AVENUE
City	PORT HURON
State	MI
ZIP	48060
Phone	810 660-0242
CertificateType	4
CertificateEffectiveDate	5/17/2023
CertificateExpirationDate	5/16/2025
FacilityType	Waiver

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