CLIA lab
CLIA 23D0904212: Mymichigan Family Medicine
Ithaca, MI. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 23D0904212 belongs to Mymichigan Family Medicine in Ithaca, MI.
Certificate of Waiver, effective August 11, 2025, expires August 10, 2027.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- August 11, 2025
- Certificate expiration
- August 10, 2027
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- August 11, 1995
- Facility type
- Physician office
- Ownership (control type)
- Other
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 23D0904212
- Lab name
- Mymichigan Family Medicine
- Address
- 121 N Pine River Street, Ithaca, MI 48847
- Phone
- (989) 875-5111
- Fax
- (989) 875-5023
Annual test volume the lab reported
- Waived tests
- 500
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
Other labs in Ithaca, MI
- Gratiot County JailCertificate of Waiver, Other23D2206918
- Gratiot County SheriffCertificate of Waiver, Prison23D2203759
- Ithaca Family PracticeCertificate of Waiver, Physician office23D0375770
- University of Michigan Health -Certificate of Waiver, Physician office23D0692555
- University of Michigan Health SparrowCertificate of Waiver, Physician office23D1009306
Related
Questions
What is the CLIA number for Mymichigan Family Medicine in Ithaca?
23D0904212, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Mymichigan Family Medicine hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 23D0904212 expire?
The CMS file lists August 10, 2027 as the certificate expiration date; the certificate took effect August 11, 2025.