23D2304811 CLIA NUMBER - MCLAREN PORT HURON ACADEMIC CENTER FOR FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 23D2304811
  • Facility Name: MCLAREN PORT HURON ACADEMIC CENTER FOR FAMILY MEDICINE
  • Facility Address: 1313 STONE STREET
    PORT HURON, MI
    ZIP 48060
  • Facility Phone: 810 985-2620
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BLAIR G. DOWDEN III
  • NPI Number: 1669624318
  • Taxonomy: 367500000X - Nurse Anesthetist, Certified Registered

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CLIA Record

Field Name Field Value
CLIA Number 23D2304811
LAB Type Physician Office
Facility Name MCLAREN PORT HURON ACADEMIC CENTER FOR FAMILY MEDICINE
Street 1313 STONE STREET
City PORT HURON
State MI
ZIP 48060
Phone 810 985-2620
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2024
Certificate Expiration Date 5/19/2026
Facility Type Physician Office
Lab Director BLAIR G. DOWDEN III

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This page was last updated on: 3/20/2025