23D2293243 CLIA NUMBER - DOCKSIDE MEDICAL PLC DBA DOCKSIDE FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 23D2293243
  • Facility Name: DOCKSIDE MEDICAL PLC DBA DOCKSIDE FAMILY MEDICINE
  • Facility Address: 401 E HURON ROAD BLDG B
    AU GRES, MI
    ZIP 48703
  • Facility Phone: 989 314-0317
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: REBECCA A. BRITT-DEWYER
  • NPI Number: 1447936539
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 23D2293243
LAB Type Physician Office
Facility Name DOCKSIDE MEDICAL PLC DBA DOCKSIDE FAMILY MEDICINE
Street 401 E HURON ROAD BLDG B
City AU GRES
State MI
ZIP 48703
Phone 989 314-0317
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/6/2023
Certificate Expiration Date 11/5/2025
Facility Type Physician Office
Lab Director REBECCA A. BRITT-DEWYER

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