23D2312442 CLIA NUMBER - BLUE WATER URGENT CARE MARYSVILLE

Laboratory Demographics

  • CLIA Code: 23D2312442
  • Facility Name: BLUE WATER URGENT CARE MARYSVILLE
  • Facility Address: 1600 GRATIOT BLVD BUILDING 1A
    MARYSVILLE, MI
    ZIP 48040
  • Facility Phone: 810 676-3360
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: IBRAHIM H. DABAJA
  • NPI Number: 1821834805
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 23D2312442
LAB Type Physician Office
Facility Name BLUE WATER URGENT CARE MARYSVILLE
Street 1600 GRATIOT BLVD BUILDING 1A
City MARYSVILLE
State MI
ZIP 48040
Phone 810 676-3360
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2024
Certificate Expiration Date 10/10/2026
Facility Type Physician Office
Lab Director IBRAHIM H. DABAJA

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