23D2312509 CLIA NUMBER - PHOENIX HOUSE, INC

Laboratory Demographics

  • CLIA Code: 23D2312509
  • Facility Name: PHOENIX HOUSE, INC
  • Facility Address: 57467 WATERWORKS ROAD
    CALUMET, MI
    ZIP 49913
  • Facility Phone: 906 337-0763
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: MARK MAGGIO
  • NPI Number: 1841464492
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 23D2312509
LAB Type Comp. Outpatient Rehab Facility
Facility Name PHOENIX HOUSE, INC
Street 57467 WATERWORKS ROAD
City CALUMET
State MI
ZIP 49913
Phone 906 337-0763
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Comp. Outpatient Rehab Facility
Lab Director MARK MAGGIO

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